Company Detail

Job Description

Responsible for creation and maintenance of member and provider eligibility records. Research and reconcile authorization data to ensure accuracy. Perform manual entry of authorizations into various client systems. Comfortable with high degree of contact with case managers, client contacts, and providers.

• Evaluates data and determines what process is required for specific systems and accounts.

• Processes member enrollment and change of coverage requests.

• Verifies provider contractual status.

• Corresponds with contacts regarding member and provider data.

• Resolves problems with automated transmission of authorizations.

• Responsible for timely and accurate keying of authorizations in client systems.

  Other Job Requirements

Responsibilities

Minimum of 1 year customer service, claims, or general office experience.Proficient with MS Office software.Ability to type 60 WPM.Strong ten key user.Results and solution oriented; not afraid to ask questions

General Job Information

Title

Eligibility Processor I

Grade

16

Work Experience - Required

Claims, 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.

Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive.

Magellan is committed to providing equal employment opportunities to employees and applicants for employment without regard to race, color, creed, religion, sex, gender identity and expression, sexual orientation, marital status, age, national origin, ancestry, citizenship, physical or mental disability, disabled veteran or veteran of the Vietnam Era status, or any other factors protected by law.

Magellan is committed to meeting applicable Federal labor and employment law posting requirements by providing necessary posters in a format which is easily accessible and conspicuous to all applicants. Copies of applicable posters are accessible by clicking here (https://www.magellanhealth.com/media/760295/mg-federal-contractors-applicant-english.pdf) .

Warning: Employment Scam

It has come to our attention that a false representative is contacting potential candidates and offering them work at home positions with Magellan Health. -Interviews- are conducted completely through email and the false job offer includes the promise of a check to be issued to the candidate for the purposes of setting up a home office.

Please know that Magellan Health does not interview any candidate through email, nor do we issue checks to candidates to set up home offices. All of our available positions are posted on legitimate job boards and our recruitment team directly contacts candidates should there be a fit.

If you suspect you are being contacted by a false representative of Magellan Health, please call 410-953-2911

Job Detail

• Company:
  Magellan Health Services

Job Description

The successful candidate will be a part of the MRx Knowledge Expansion Program. This program will pair you with a mentor and expose you to an array of senior colleagues. In addition to learning the details of your job and will also be given the opportunity to build a broad range of subject matter expertise.

This is a fully remote opportunity, allowing you to work from the comfort of your own home.

This position will analyze, evaluate and design/redesign business, IT or operational processes using scientific approaches such as Critical Thinking, Lean Management, ITIL, Design Thinking and structured systems analysis and design. Provide coaching and mentoring to more junior staff. Work with a variety of development roles to understand the overall technical architecture and how each feature is implemented. Is highly collaborative and comfortable communicating cross-functionally and across management levels in formal and informal settings. Have strong analytical skills and a relentless determination to do what is right for customers. Good at multi-tasking, juggling competing priorities, and organizing oneself. Deep understanding of the business/technical domain.

• Lead design, planning, and implementation of requirements to satisfy business needs.

• Authority on best practices of requirements gathering, business system configuration and defining/execution of acceptance criteria.

• Work with the technical teams and the business/product owner to ensure efficiency, smooth and successful implementation.

• Coach and mentor junior staff in requirements documentation, systems configuration, defining/execution of acceptance criteria and establishing, tracking, measuring and refining metrics.

• Improve product feature offerings by providing feedback to internal cross-functional teams including IT Project Manager, Business/Product owner and Software Engineering.

• Identify, drive, and optimize technical and business process flows for existing and new opportunities.

• Partner with teams to define systems improvement focusing on scale, efficiency, and automation.

• Work with internal business groups to acquire a deep understanding of their processes and operations.

• Understand software internals, debug problems using log files, and write automated tests with Perl/JavaScript and/or user-level test automation tools.

• Strong organizational skills, tracking multiple test executions simultaneously and be able to synthesize the results.

• Meticulous attention to detail; the ability to juggle many tasks in parallel while delivering high quality results.

• Works/Collaborates with Software Engineers to understand features and technical implementation and ensure highest quality product delivery.

• Drive the software development process toward quality-centric methodologies.

• Other duties as assigned.

  Other Job Requirements

Responsibilities

5+ years related experience including a minimum of 2+ years developing requirements, designing and executing test cases in IT.Ability to synthesize complex information and explain it to others in technical and non-technical terms.Experience with a variety of QA methodology and problem solving tools/techniques.Detail-oriented person who is passionate about quality and is enthusiastic about the new technology offered to customers.Experience with and a passion for translating user-interface design into requirements and acceptance criteria.Ability to lead other team members through resolving challenges.Mastery of creating and executing test cases.Experience in Perl/Python/JavaScript scripting and user-level automation.Excellent customer experience intuition; demonstrated success in delivering a world-class customer experience.Experience with Lean methods.Experience with diagraming and visual communications. Certification in Training in Design Thinking.

General Job Information

Title

Lead IT Analyst - Remote

Grade

26

Work Experience - Required

IT

Work Experience - Preferred

Education - Required

A Combination of Education and Work Experience May Be Considered., Bachelors - Computer and Information Science

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.

Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive.

Magellan is committed to providing equal employment opportunities to employees and applicants for employment without regard to race, color, creed, religion, sex, gender identity and expression, sexual orientation, marital status, age, national origin, ancestry, citizenship, physical or mental disability, disabled veteran or veteran of the Vietnam Era status, or any other factors protected by law.

Magellan is committed to meeting applicable Federal labor and employment law posting requirements by providing necessary posters in a format which is easily accessible and conspicuous to all applicants. Copies of applicable posters are accessible by clicking here (https://www.magellanhealth.com/media/760295/mg-federal-contractors-applicant-english.pdf) .

Warning: Employment Scam

It has come to our attention that a false representative is contacting potential candidates and offering them work at home positions with Magellan Health. -Interviews- are conducted completely through email and the false job offer includes the promise of a check to be issued to the candidate for the purposes of setting up a home office.

Please know that Magellan Health does not interview any candidate through email, nor do we issue checks to candidates to set up home offices. All of our available positions are posted on legitimate job boards and our recruitment team directly contacts candidates should there be a fit.

If you suspect you are being contacted by a false representative of Magellan Health, please call 410-953-2911

Job Detail

• Company:
  Magellan Health Services

Job Description

• Support EBS 12.2.X and 12C Database On Oracle Cloud Infrastructure

• Should have knowledge of Cloud Manager for cloning EBS environment

• Perform patching, cloning, taking backups, managing archives and regular maintenance activities

• Coordinate with Oracle, Application Support team, Unix/Linux/storage and other Application teams

• Experienced in troubleshooting Oracle Application configuration and infrastructure issues

• Exposure and hands on Performance tuning of instance and application

• Experience and hands on shell scripting

• Experience with Oracle RAC, Data Guard, RMAN Backups and Restore, OEM

• Good understanding on Architecture and infrastructure (servers)

• Perform database monitoring, tuning, and capacity planning

• Manage Oracle ASM environments

• Manage and maintain databases using Oracle Enterprise Manager

• Develop automated solutions to everyday tasks using BASH/SHELL/SQL/PLSQL scripts

• Should be able to available to provide after hours support

This position leads an infrastructure team and coordinates projects to meet client needs. Builds a strong team by setting example, encouraging T-shaped skills and provide the necessary training and mentoring to accomplish these goals. Coaches the team to grow the capabilities of other engineers on the team as well as providing administrative support. Ensures that's the standards and procedures are followed during design and implementation of information systems. Responsible for monitoring the systems to ensure the highest level of infrastructure performance. Works with customer to define epics and refine requirements into actionable stories. Conducts employee reviews, staffing and other resource management tasks.

• Sets team goals and prioritizes tasks to align with company and department objectives. Communicates these goals to team members. Measures progress and results of team performance.

• Ensures that all work is getting accomplished by making assignments and monitoring tasks. This includes balancing work between Database Administrators, Leads, and Supervisors, and ensuring proper policies and procedures are followed.

• Manages all aspects of team staffing including hiring, employee retention, employee development and training. Assesses and evaluates individual capabilities using clear and consistent performance standards. Provides feedback and coaching to staff both formally and informally.

• Coordinates, guides and mentors project management efforts performed by staff to ensure all tasks are completed successfully and on time.

• 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.

• Acts as liaison to assigned SBUs and management team to stay abreast of changing departmental needs.

• Provides status reports to Management as appropriate, highlighting risks and issues.

• Assists with budget preparation and management.

• Manages to 24x7x365 staff coverage.

• Special projects as assigned by management.

  Other Job Requirements

Responsibilities

7+ years of related experience including a minimum of 3+ years of designing, building and maintaining high quality, secure infrastructure systems in IT, experience working with Agile Methods and modern data center and cloud environments.Experience moving across different departments within IT to gain a broader perspective of the business/industry. Familiar with a variety of concepts, practices, and procedures.Critical thinker.Demonstrated problem solving techniques.Strong verbal and written communication skills.Ability to coach and build skills within the team.Experience in health care, insurance or related field.

General Job Information

Title

Principal Oracle Application DBA - Remote

Grade

29

Work Experience - Required

IT

Work Experience - Preferred

Education - Required

Education - Preferred

Bachelors - Computer and Information Science

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.

Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive.

Magellan is committed to providing equal employment opportunities to employees and applicants for employment without regard to race, color, creed, religion, sex, gender identity and expression, sexual orientation, marital status, age, national origin, ancestry, citizenship, physical or mental disability, disabled veteran or veteran of the Vietnam Era status, or any other factors protected by law.

Magellan is committed to meeting applicable Federal labor and employment law posting requirements by providing necessary posters in a format which is easily accessible and conspicuous to all applicants. Copies of applicable posters are accessible by clicking here (https://www.magellanhealth.com/media/760295/mg-federal-contractors-applicant-english.pdf) .

Warning: Employment Scam

It has come to our attention that a false representative is contacting potential candidates and offering them work at home positions with Magellan Health. -Interviews- are conducted completely through email and the false job offer includes the promise of a check to be issued to the candidate for the purposes of setting up a home office.

Please know that Magellan Health does not interview any candidate through email, nor do we issue checks to candidates to set up home offices. All of our available positions are posted on legitimate job boards and our recruitment team directly contacts candidates should there be a fit.

If you suspect you are being contacted by a false representative of Magellan Health, please call 410-953-2911

Job Detail

• Company:
  Magellan Health Services

Job Description

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

Work Experience - Preferred

Education - Required

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.

Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive.

Magellan is committed to providing equal employment opportunities to employees and applicants for employment without regard to race, color, creed, religion, sex, gender identity and expression, sexual orientation, marital status, age, national origin, ancestry, citizenship, physical or mental disability, disabled veteran or veteran of the Vietnam Era status, or any other factors protected by law.

Magellan is committed to meeting applicable Federal labor and employment law posting requirements by providing necessary posters in a format which is easily accessible and conspicuous to all applicants. Copies of applicable posters are accessible by clicking here (https://www.magellanhealth.com/media/760295/mg-federal-contractors-applicant-english.pdf) .

Warning: Employment Scam

It has come to our attention that a false representative is contacting potential candidates and offering them work at home positions with Magellan Health. -Interviews- are conducted completely through email and the false job offer includes the promise of a check to be issued to the candidate for the purposes of setting up a home office.

Please know that Magellan Health does not interview any candidate through email, nor do we issue checks to candidates to set up home offices. All of our available positions are posted on legitimate job boards and our recruitment team directly contacts candidates should there be a fit.

If you suspect you are being contacted by a false representative of Magellan Health, please call 410-953-2911

Job Detail

• Company:
  Magellan Health Services

Job Description

The Proposal Quality Manager has overall accountability for proposal integrity, plays an integral role in ensuring that MRx's value proposition and strategic solution is effectively communicated in its proposals and is responsible for maintaining the quality level of their assigned proposals. Reviews moderate and high-complexity proposals to ensure the proposals convey MRx's win strategy effectively and are in compliance with RFP requirements.

• Participates in internal strategy meetings to understand each opportunity prior to review.

• Identifies opportunities for improvement and provides constructive feedback to proposal writers.

• Delivers feedback to leadership regarding writer performance and opportunities for development.

• Partners with Proposal leadership to ensure the successful onboarding and development of associates on the MRx Proposal team.

• Plays a critical role in developing the skills of new hires and uplifting the talent of existing associates.

• Analyzes documentation to determine client requirements and sales strategy

• Translates directions, strategy, and client requirements into effective marketing text.

• Unites with sales executives to reinforce a customized sales strategy.

• Completes strategic review document for each reviewed proposal and provides to management team.

• Ensures newly developed content is identified for inclusion in the proposal library.

• Tracks proposal quality measures, identifies areas for improvement and collaborates with proposal management team on potential solutions.

• Reviews and updates consultant/broker templates based on new proposal content.

  Other Job Requirements

Responsibilities

10+ years' proven proposal experience in creating succinct, comprehensive, and captivating proposals that meet high standards.Bachelor's degree required with a focus in English, Journalism, Communications or a healthcare-related field.5-8 years' competitive proposal writing/proposal management/proposal quality experience for a healthcare organization or PBM.Excellent industry/consultant knowledge with a comprehensive understanding of the PBM, Managed Care or Behavioral Health industry. Understands the similarities and nuances between different PBM lines of businesses including managed care, employer, specialty, Medicare Part D, Medicaid and Exchange. Has a solid understanding of regulatory aspects of Medicare Part D and Medicaid.Innate ability to influence individuals outside of chain of command to perform at peak performance levels via effective and motivating communication skills.Aptitude to prioritize and execute on multiple projects and manage several timelines simultaneously within a fast-paced, time sensitive and results oriented environment.Exceptional writing, editing and strategy skills including a keen ability to provide constructive feedback.Proficient in Microsoft Office Products.Established track record of working effectively across multiple functions and levels in a collaborative organization.

General Job Information

Title

Proposal Quality Manager

Grade

28

Work Experience - Required

Healthcare, Proposals

Work Experience - Preferred

Education - Required

Bachelors

Education - Preferred

Masters

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.

Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive.

Magellan is committed to providing equal employment opportunities to employees and applicants for employment without regard to race, color, creed, religion, sex, gender identity and expression, sexual orientation, marital status, age, national origin, ancestry, citizenship, physical or mental disability, disabled veteran or veteran of the Vietnam Era status, or any other factors protected by law.

Magellan is committed to meeting applicable Federal labor and employment law posting requirements by providing necessary posters in a format which is easily accessible and conspicuous to all applicants. Copies of applicable posters are accessible by clicking here (https://www.magellanhealth.com/media/760295/mg-federal-contractors-applicant-english.pdf) .

Warning: Employment Scam

It has come to our attention that a false representative is contacting potential candidates and offering them work at home positions with Magellan Health. -Interviews- are conducted completely through email and the false job offer includes the promise of a check to be issued to the candidate for the purposes of setting up a home office.

Please know that Magellan Health does not interview any candidate through email, nor do we issue checks to candidates to set up home offices. All of our available positions are posted on legitimate job boards and our recruitment team directly contacts candidates should there be a fit.

If you suspect you are being contacted by a false representative of Magellan Health, please call 410-953-2911

Job Detail

• Company:
  Magellan Health Services

Job Description

This position is responsible for the support of all activities related to developing and maintaining the physician, practitioner, group, and/or facility, MPPS and organization services delivery system in small to mid-size market defined by membership, number of providers in delivery system, number of business operating units and lines of business. Interacts with all areas of organization to coordinate network management and network administration responsibilities.

• Assesses network needs, analyzes network composition, and using organization databases, application of regulatory requirements, accreditation entities and other resources, recruits individual, group and/or organizational providers to meet network adequacy standards and assure quality network.

• Conducts and coordinates contracting and amendment initiatives.

• Provides issue resolution and complex trouble shooting for providers.

• Conducts provider education and provider relation activities, providing necessary written materials.

• Conducts administrative provider site visits and coordinates report development and completion according to contractual requirements or ad hoc requests.

• Coordinates Public Policy Research Center (PPRC) activities to assure maintenance of current credentialing status, and evaluation and appropriate actions of quality of care issues and complaints against providers.

• Conducts and manages ongoing audits of provider compliance with Magellan policies and procedures as well as contractual obligations for multiple customers. Develops work plans to address audit requirements.

• Works with management to draft, clarify and recommend changes to policies which impact network management.

  Other Job Requirements

Responsibilities

Knowledge of National Committee for Quality Assurance (NCQA) requirements.Ability to work independently and prioritize activities.Intermediate knowledge of Microsoft Office Suite, specifically Excel.Strong presentations skills using PowerPoint.Minimum of 1 year experience in related position/field.

General Job Information

Title

Provider Network Management Specialist

Grade

20

Work Experience - Required

Network

Work Experience - Preferred

Education - Required

Education - Preferred

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.

Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive.

Magellan is committed to providing equal employment opportunities to employees and applicants for employment without regard to race, color, creed, religion, sex, gender identity and expression, sexual orientation, marital status, age, national origin, ancestry, citizenship, physical or mental disability, disabled veteran or veteran of the Vietnam Era status, or any other factors protected by law.

Magellan is committed to meeting applicable Federal labor and employment law posting requirements by providing necessary posters in a format which is easily accessible and conspicuous to all applicants. Copies of applicable posters are accessible by clicking here (https://www.magellanhealth.com/media/760295/mg-federal-contractors-applicant-english.pdf) .

Warning: Employment Scam

It has come to our attention that a false representative is contacting potential candidates and offering them work at home positions with Magellan Health. -Interviews- are conducted completely through email and the false job offer includes the promise of a check to be issued to the candidate for the purposes of setting up a home office.

Please know that Magellan Health does not interview any candidate through email, nor do we issue checks to candidates to set up home offices. All of our available positions are posted on legitimate job boards and our recruitment team directly contacts candidates should there be a fit.

If you suspect you are being contacted by a false representative of Magellan Health, please call 410-953-2911

Job Detail

• Company:
  Magellan Health Services

Job Description

Responsible for timely and accurate client record maintenance. Support Client Billing and remittance. Research and resolve questions, complaints and grievances and ensure information in all databases is accurate and properly configured to support operations and properly record revenue. Support Management by communicating report results through meetings/e-mails to help mitigate revenue risks. Record all contracting information regarding billing and adheres to Sarbanes Oxley Policies for Employer Solutions.

• Ensures Billing System is updated timely, appropriately and accurately to support accurate Client Remittance and proper revenue recognition for assigned Clients including all new business. Ensures timely deliver of billing cycled invoices to Clients.

• Prepares fee for service spreadsheet for billing and includes the individual billing to all customers.

• Researches and responds in a professional and timely manner to inquiries from both clients and other Internal Staff.

• Researches information regarding complex inquiries, develops solutions, and communicates professionally the outcome by telephone and in writing. Communicates with Account Executives to ensure that Client data is gathered in a timely manner.

• Responds to client/account management requests to update/change client information and ensures that all changes are made within operational guidelines and accurately support all other system related functions.

• Follows through on additional requests/projects as requested by Management.

  Other Job Requirements

Responsibilities

1+ Years Accounts Receivable experience including Billing, Reconciliations, and Collections.Intermediate level MS Excel, Ten-Key by touch, must be detail oriented, decipher contract language, and compute billing adjustments manually.

General Job Information

Title

Billing Specialist I

Grade

17

Work Experience - Required

Finance

Work Experience - Preferred

Education - Required

GED, High School

Education - Preferred

Associates

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.

Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive.

Magellan is committed to providing equal employment opportunities to employees and applicants for employment without regard to race, color, creed, religion, sex, gender identity and expression, sexual orientation, marital status, age, national origin, ancestry, citizenship, physical or mental disability, disabled veteran or veteran of the Vietnam Era status, or any other factors protected by law.

Magellan is committed to meeting applicable Federal labor and employment law posting requirements by providing necessary posters in a format which is easily accessible and conspicuous to all applicants. Copies of applicable posters are accessible by clicking here (https://www.magellanhealth.com/media/760295/mg-federal-contractors-applicant-english.pdf) .

Warning: Employment Scam

It has come to our attention that a false representative is contacting potential candidates and offering them work at home positions with Magellan Health. -Interviews- are conducted completely through email and the false job offer includes the promise of a check to be issued to the candidate for the purposes of setting up a home office.

Please know that Magellan Health does not interview any candidate through email, nor do we issue checks to candidates to set up home offices. All of our available positions are posted on legitimate job boards and our recruitment team directly contacts candidates should there be a fit.

If you suspect you are being contacted by a false representative of Magellan Health, please call 410-953-2911

Job Detail

• Company:
  Magellan Health Services

Job Description

This position will analyze, evaluate and redesign business, IT or operational processes using scientific approaches such as Critical Thinking, Lean Management, ITIL, Design Thinking and structured systems analysis and design. Work quickly and independently while delivering high-quality outputs. Use strong organizational skills for tracking multiple deliverables simultaneously and be able to synthesize the results. Pay meticulous attention to detail; the ability to juggle many tasks in parallel without lowering the quality bar. Collaborate with Software Engineers to understand features and technical implementation and ensure highest quality product delivery. Develop deep understanding of the business/technical domain.

• Independently participate in requirements documentation, business systems configuration and defining/execution of acceptance criteria. Document issues and participate in their resolution.

• Work closely with development and business teams to understand business requirements.

• Translate business needs into high-level technical specifications and design. Identify gaps and ensure deployment of solutions.

• Support business-critical systems using mature IT and software engineering practices.

• Develop, deploy, and execute test strategies.

• Work with team to ensure the highest quality product delivery.

• Work closely with cross functional teams and across boundary organizations to gather requirements, define solutions, implement new tools and process, and provide ongoing support to these teams.

• Test applications and products at the user level, both manually and with automated tools.

• Develop deep understanding of the applications that he/she/they support.

• Communicating cross-functionally and across management levels in formal and informal settings.

• Track multiple test executions simultaneously and synthesize the results.

  Other Job Requirements

Responsibilities

3+ years related experience including developing requirements, designing and executing test cases in ITExperience with QA methodology and problem solving techniques/tools.Detail-oriented person who is passionate about quality and is enthusiastic about the new technology offered to customers.Demonstrated software testing experience.Excellent written and oral communication skills.Meticulous attention to detail; the ability to juggle several tasks in parallel without lowering your quality bar.Experience with analytical programming languages such as SQL.Ability to thrive in ambiguity and rapid change.Experience with process flow diagrams.Experience with applying Agile Methods.

General Job Information

Title

Senior Business Analyst - PBM Core Operations

Grade

25

Work Experience - Required

IT

Work Experience - Preferred

Education - Required

A Combination of Education and Work Experience May Be Considered., Bachelors - Computer and Information Science

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.

Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive.

Magellan is committed to providing equal employment opportunities to employees and applicants for employment without regard to race, color, creed, religion, sex, gender identity and expression, sexual orientation, marital status, age, national origin, ancestry, citizenship, physical or mental disability, disabled veteran or veteran of the Vietnam Era status, or any other factors protected by law.

Magellan is committed to meeting applicable Federal labor and employment law posting requirements by providing necessary posters in a format which is easily accessible and conspicuous to all applicants. Copies of applicable posters are accessible by clicking here (https://www.magellanhealth.com/media/760295/mg-federal-contractors-applicant-english.pdf) .

Warning: Employment Scam

It has come to our attention that a false representative is contacting potential candidates and offering them work at home positions with Magellan Health. -Interviews- are conducted completely through email and the false job offer includes the promise of a check to be issued to the candidate for the purposes of setting up a home office.

Please know that Magellan Health does not interview any candidate through email, nor do we issue checks to candidates to set up home offices. All of our available positions are posted on legitimate job boards and our recruitment team directly contacts candidates should there be a fit.

If you suspect you are being contacted by a false representative of Magellan Health, please call 410-953-2911

Job Detail

• Company:
  Magellan Health Services

Job Description

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.

Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive.

Magellan is committed to providing equal employment opportunities to employees and applicants for employment without regard to race, color, creed, religion, sex, gender identity and expression, sexual orientation, marital status, age, national origin, ancestry, citizenship, physical or mental disability, disabled veteran or veteran of the Vietnam Era status, or any other factors protected by law.

Magellan is committed to meeting applicable Federal labor and employment law posting requirements by providing necessary posters in a format which is easily accessible and conspicuous to all applicants. Copies of applicable posters are accessible by clicking here (https://www.magellanhealth.com/media/760295/mg-federal-contractors-applicant-english.pdf) .

Warning: Employment Scam

It has come to our attention that a false representative is contacting potential candidates and offering them work at home positions with Magellan Health. -Interviews- are conducted completely through email and the false job offer includes the promise of a check to be issued to the candidate for the purposes of setting up a home office.

Please know that Magellan Health does not interview any candidate through email, nor do we issue checks to candidates to set up home offices. All of our available positions are posted on legitimate job boards and our recruitment team directly contacts candidates should there be a fit.

If you suspect you are being contacted by a false representative of Magellan Health, please call 410-953-2911

Job Detail

• Company:
  Magellan Health Services

Job Description

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.

Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive.

Magellan is committed to providing equal employment opportunities to employees and applicants for employment without regard to race, color, creed, religion, sex, gender identity and expression, sexual orientation, marital status, age, national origin, ancestry, citizenship, physical or mental disability, disabled veteran or veteran of the Vietnam Era status, or any other factors protected by law.

Magellan is committed to meeting applicable Federal labor and employment law posting requirements by providing necessary posters in a format which is easily accessible and conspicuous to all applicants. Copies of applicable posters are accessible by clicking here (https://www.magellanhealth.com/media/760295/mg-federal-contractors-applicant-english.pdf) .

Warning: Employment Scam

It has come to our attention that a false representative is contacting potential candidates and offering them work at home positions with Magellan Health. -Interviews- are conducted completely through email and the false job offer includes the promise of a check to be issued to the candidate for the purposes of setting up a home office.

Please know that Magellan Health does not interview any candidate through email, nor do we issue checks to candidates to set up home offices. All of our available positions are posted on legitimate job boards and our recruitment team directly contacts candidates should there be a fit.

If you suspect you are being contacted by a false representative of Magellan Health, please call 410-953-2911

Job Detail

• Company:
  Magellan Health Services

Job Description

MUST be able to work 9:30am to 6:30pm Monday through Friday 3/21/22-5/13/22 followed by post training schedule of four 10 hour workdays Monday, Tuesday, Thursday and Friday 11:30am to 10:00pm eastern standard time.

Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria.

• Determines appropriateness for medications. Communicates decision to physicians, physician`s office staff, medical management staff and/or pharmacists.

• Researches, resolves and documents prior authorization outcomes in pharmacy system.

• Communicates selected prior authorization criteria, pharmacy benefit coverage and formulary alternatives to physicians, physician`s office staff, medical management staff and/or pharmacists.

• Escalates requests to Pharmacist when request requires extensive clinical review or denial.

• Researches, resolves and documents physician or client inquiries and grievances and provides verbal or written results to client, prescriber, provider and/or management.

• Performs other duties as required.

  Other Job Requirements

Responsibilities

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).Active Pharmacist license supersedes requirement for CPT and/or PTCB.Specialty or retail pharmacy industry experience, previous reimbursement experience, and/or working in a health plan/health care setting.In-depth knowledge of specialty injectable prescription drugs, disease states, health plan formulary management techniques, medical terminology and current diagnostic and reimbursement coding (J/Q codes, ICD-9, CMS 1500, etc.).Proficiency in Pharmacy computerized systems and software applications, as well as MS Office Product Suite.Excellent written and verbal communication skills.Ability to follow clinical criteria and instructions to approve prior authorization requests.Minimum of 6 months dispensing or retail experience required, or equivalent internal training will be substituted.Ability to identify and trouble-shoot problematic issues.

General Job Information

Title

Remote Clinical Pharmacy Technician, post training schedule four 10 hour workdays Mon, Tues, Thurs Fri 11:30am to 10:00pm EST

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

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.

Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive.

Magellan is committed to providing equal employment opportunities to employees and applicants for employment without regard to race, color, creed, religion, sex, gender identity and expression, sexual orientation, marital status, age, national origin, ancestry, citizenship, physical or mental disability, disabled veteran or veteran of the Vietnam Era status, or any other factors protected by law.

Magellan is committed to meeting applicable Federal labor and employment law posting requirements by providing necessary posters in a format which is easily accessible and conspicuous to all applicants. Copies of applicable posters are accessible by clicking here (https://www.magellanhealth.com/media/760295/mg-federal-contractors-applicant-english.pdf) .

Warning: Employment Scam

It has come to our attention that a false representative is contacting potential candidates and offering them work at home positions with Magellan Health. -Interviews- are conducted completely through email and the false job offer includes the promise of a check to be issued to the candidate for the purposes of setting up a home office.

Please know that Magellan Health does not interview any candidate through email, nor do we issue checks to candidates to set up home offices. All of our available positions are posted on legitimate job boards and our recruitment team directly contacts candidates should there be a fit.

If you suspect you are being contacted by a false representative of Magellan Health, please call 410-953-2911

Job Detail

• Company:
  Magellan Health Services

Job Description

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.

Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive.

Magellan is committed to providing equal employment opportunities to employees and applicants for employment without regard to race, color, creed, religion, sex, gender identity and expression, sexual orientation, marital status, age, national origin, ancestry, citizenship, physical or mental disability, disabled veteran or veteran of the Vietnam Era status, or any other factors protected by law.

Magellan is committed to meeting applicable Federal labor and employment law posting requirements by providing necessary posters in a format which is easily accessible and conspicuous to all applicants. Copies of applicable posters are accessible by clicking here (https://www.magellanhealth.com/media/760295/mg-federal-contractors-applicant-english.pdf) .

Warning: Employment Scam

It has come to our attention that a false representative is contacting potential candidates and offering them work at home positions with Magellan Health. -Interviews- are conducted completely through email and the false job offer includes the promise of a check to be issued to the candidate for the purposes of setting up a home office.

Please know that Magellan Health does not interview any candidate through email, nor do we issue checks to candidates to set up home offices. All of our available positions are posted on legitimate job boards and our recruitment team directly contacts candidates should there be a fit.

If you suspect you are being contacted by a false representative of Magellan Health, please call 410-953-2911

Job Detail

• Company:
  Magellan Health Services

Job Description

IMPORTANT - this is a flex role and this person will be required to go into the Maryland Heights office once per week.

Independently performs quality functions within the Quality Department of a Care Center or office. Coordinates projects resulting in continuous quality improvement and process improvement. Supports the maintenance of a strong quality program, measured processes and reported outcomes.

• Coordinates assigned quality and process improvement activities which may include accreditation support, process improvement projects and monitoring of performance guarantees.

• Conducts quality control reviews and internal audits.

• Summarizes findings and prepare reports on findings.

• Assists in the preparation of customer and external audits.

  Other Job Requirements

Responsibilities

Up to 2 years of quality improvement and auditing or related in healthcare field.Knowledge of healthcare quality improvement processes and performance measurement.Attention to detail and ability to work efficiently to meet deadlines and timelines.High degree of organization required.Expertise in data management, data analysis, reporting word processing, and project management skills.Strong working knowledge of Microsoft Excel, VISIO and MS Project.

General Job Information

Title

Quality Specialist - St. Louis, MO

Grade

21

Work Experience - Required

Quality

Work Experience - Preferred

Education - Required

Education - Preferred

Bachelors - Healthcare

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.

Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive.

Magellan is committed to providing equal employment opportunities to employees and applicants for employment without regard to race, color, creed, religion, sex, gender identity and expression, sexual orientation, marital status, age, national origin, ancestry, citizenship, physical or mental disability, disabled veteran or veteran of the Vietnam Era status, or any other factors protected by law.

Magellan is committed to meeting applicable Federal labor and employment law posting requirements by providing necessary posters in a format which is easily accessible and conspicuous to all applicants. Copies of applicable posters are accessible by clicking here (https://www.magellanhealth.com/media/760295/mg-federal-contractors-applicant-english.pdf) .

Warning: Employment Scam

It has come to our attention that a false representative is contacting potential candidates and offering them work at home positions with Magellan Health. -Interviews- are conducted completely through email and the false job offer includes the promise of a check to be issued to the candidate for the purposes of setting up a home office.

Please know that Magellan Health does not interview any candidate through email, nor do we issue checks to candidates to set up home offices. All of our available positions are posted on legitimate job boards and our recruitment team directly contacts candidates should there be a fit.

If you suspect you are being contacted by a false representative of Magellan Health, please call 410-953-2911

Job Detail

• Company:
  Magellan Health Services

Job Description

This position is responsible for status reports, resolving issues and client escalations. Will assist with resource allocations and implementation activities and will escalate to the manager any issues they cannot resolve. Will remain up to date on current processes and concerns.

• Works with manufacturers and client pertaining to dispute resolution.

• Assists client with Pharmacy audits providing requested information and support.

• Assisting with payment posting, dunning letter mailings and maintaining all client service agreements.

• Invoicing practices, including pre-invoicing review for fee for service, managed care, diabetic supply and supplemental rebate programs.

• Assists account management and rebate management with client requests such as ad hoc reporting.

• Identify areas of improvement and follows through to implementation.

• Assists with application updates and testing.

• Attends meetings and conference calls with clients and drug manufacturers and internal meetings.

  Other Job Requirements

Responsibilities

1+ years' experience in an accounting environment, accounts receivable and/or invoicing. Associate's degree in Accounting or Finance.Will accept equivalent combination of education and experience.Strong verbal and written communication skills.Strong working knowledge of Microsoft Word and Excel.

General Job Information

Title

Pharmacy Rebate Analyst - Glen Allen, VA

Grade

19

Work Experience - Required

Accounting, Accounts Receivable

Work Experience - Preferred

Education - Required

A Combination of Education and Work Experience May Be Considered., Bachelors - Accounting, Bachelors - Finance

Education - Preferred

License and Certifications - Required

License and Certifications - Preferred

CPA - Certified Public Accountant - Enterprise, CPT - Certified Pharmacy Technician - Pharmacy

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.

Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive.

Magellan is committed to providing equal employment opportunities to employees and applicants for employment without regard to race, color, creed, religion, sex, gender identity and expression, sexual orientation, marital status, age, national origin, ancestry, citizenship, physical or mental disability, disabled veteran or veteran of the Vietnam Era status, or any other factors protected by law.

Magellan is committed to meeting applicable Federal labor and employment law posting requirements by providing necessary posters in a format which is easily accessible and conspicuous to all applicants. Copies of applicable posters are accessible by clicking here (https://www.magellanhealth.com/media/760295/mg-federal-contractors-applicant-english.pdf) .

Warning: Employment Scam

It has come to our attention that a false representative is contacting potential candidates and offering them work at home positions with Magellan Health. -Interviews- are conducted completely through email and the false job offer includes the promise of a check to be issued to the candidate for the purposes of setting up a home office.

Please know that Magellan Health does not interview any candidate through email, nor do we issue checks to candidates to set up home offices. All of our available positions are posted on legitimate job boards and our recruitment team directly contacts candidates should there be a fit.

If you suspect you are being contacted by a false representative of Magellan Health, please call 410-953-2911

Job Detail

• Company:
  Magellan Health Services

Job Description

MUST be able to work 9:30am to 6:30pm Monday through Friday 3/21/22-5/13/22 followed by post training schedule of four 10 hour workdays Monday to Thursday 10:30am to 9:00pm eastern standard time.

Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria.

• Determines appropriateness for medications. Communicates decision to physicians, physician`s office staff, medical management staff and/or pharmacists.

• Researches, resolves and documents prior authorization outcomes in pharmacy system.

• Communicates selected prior authorization criteria, pharmacy benefit coverage and formulary alternatives to physicians, physician`s office staff, medical management staff and/or pharmacists.

• Escalates requests to Pharmacist when request requires extensive clinical review or denial.

• Researches, resolves and documents physician or client inquiries and grievances and provides verbal or written results to client, prescriber, provider and/or management.

• Performs other duties as required.

  Other Job Requirements

Responsibilities

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).Active Pharmacist license supersedes requirement for CPT and/or PTCB.Specialty or retail pharmacy industry experience, previous reimbursement experience, and/or working in a health plan/health care setting.In-depth knowledge of specialty injectable prescription drugs, disease states, health plan formulary management techniques, medical terminology and current diagnostic and reimbursement coding (J/Q codes, ICD-9, CMS 1500, etc.).Proficiency in Pharmacy computerized systems and software applications, as well as MS Office Product Suite.Excellent written and verbal communication skills.Ability to follow clinical criteria and instructions to approve prior authorization requests.Minimum of 6 months dispensing or retail experience required, or equivalent internal training will be substituted.Ability to identify and trouble-shoot problematic issues.

General Job Information

Title

Remote Clinical Pharmacy Technician; post training schedule four 10 hour work days Monday to Thursday 10:30am to 9:00pm EST

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

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.

Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive.

Magellan is committed to providing equal employment opportunities to employees and applicants for employment without regard to race, color, creed, religion, sex, gender identity and expression, sexual orientation, marital status, age, national origin, ancestry, citizenship, physical or mental disability, disabled veteran or veteran of the Vietnam Era status, or any other factors protected by law.

Magellan is committed to meeting applicable Federal labor and employment law posting requirements by providing necessary posters in a format which is easily accessible and conspicuous to all applicants. Copies of applicable posters are accessible by clicking here (https://www.magellanhealth.com/media/760295/mg-federal-contractors-applicant-english.pdf) .

Warning: Employment Scam

It has come to our attention that a false representative is contacting potential candidates and offering them work at home positions with Magellan Health. -Interviews- are conducted completely through email and the false job offer includes the promise of a check to be issued to the candidate for the purposes of setting up a home office.

Please know that Magellan Health does not interview any candidate through email, nor do we issue checks to candidates to set up home offices. All of our available positions are posted on legitimate job boards and our recruitment team directly contacts candidates should there be a fit.

If you suspect you are being contacted by a false representative of Magellan Health, please call 410-953-2911

Job Detail

• Company:
  Magellan Health Services

Job Description

MUST be able to work 9:30am to 6:30pm Monday through Friday 3/21/22-5/13/22 followed by post training schedule of Monday, Tuesday, Thursday, Friday and Saturday 10:30am to 7:00pm eastern standard time.

Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria.

• Determines appropriateness for medications. Communicates decision to physicians, physician`s office staff, medical management staff and/or pharmacists.

• Researches, resolves and documents prior authorization outcomes in pharmacy system.

• Communicates selected prior authorization criteria, pharmacy benefit coverage and formulary alternatives to physicians, physician`s office staff, medical management staff and/or pharmacists.

• Escalates requests to Pharmacist when request requires extensive clinical review or denial.

• Researches, resolves and documents physician or client inquiries and grievances and provides verbal or written results to client, prescriber, provider and/or management.

• Performs other duties as required.

  Other Job Requirements

Responsibilities

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).Active Pharmacist license supersedes requirement for CPT and/or PTCB.Specialty or retail pharmacy industry experience, previous reimbursement experience, and/or working in a health plan/health care setting.In-depth knowledge of specialty injectable prescription drugs, disease states, health plan formulary management techniques, medical terminology and current diagnostic and reimbursement coding (J/Q codes, ICD-9, CMS 1500, etc.).Proficiency in Pharmacy computerized systems and software applications, as well as MS Office Product Suite.Excellent written and verbal communication skills.Ability to follow clinical criteria and instructions to approve prior authorization requests.Minimum of 6 months dispensing or retail experience required, or equivalent internal training will be substituted.Ability to identify and trouble-shoot problematic issues.

General Job Information

Title

Remote Clinical Pharmacy Technician, post training schedule Mon, Tues, Thurs, Fri and Sat 10:30am to 7:00pm EST

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

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.

Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive.

Magellan is committed to providing equal employment opportunities to employees and applicants for employment without regard to race, color, creed, religion, sex, gender identity and expression, sexual orientation, marital status, age, national origin, ancestry, citizenship, physical or mental disability, disabled veteran or veteran of the Vietnam Era status, or any other factors protected by law.

Magellan is committed to meeting applicable Federal labor and employment law posting requirements by providing necessary posters in a format which is easily accessible and conspicuous to all applicants. Copies of applicable posters are accessible by clicking here (https://www.magellanhealth.com/media/760295/mg-federal-contractors-applicant-english.pdf) .

Warning: Employment Scam

It has come to our attention that a false representative is contacting potential candidates and offering them work at home positions with Magellan Health. -Interviews- are conducted completely through email and the false job offer includes the promise of a check to be issued to the candidate for the purposes of setting up a home office.

Please know that Magellan Health does not interview any candidate through email, nor do we issue checks to candidates to set up home offices. All of our available positions are posted on legitimate job boards and our recruitment team directly contacts candidates should there be a fit.

If you suspect you are being contacted by a false representative of Magellan Health, please call 410-953-2911

Job Detail

• Company:
  Magellan Health Services

Job Description

MUST be able to work 9:30am to 6:30pm Monday through Friday 3/21/22-5/13/22 followed by post training schedule of Monday through Friday 1:30-10:00pm eastern standard time.

Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria.

• Determines appropriateness for medications. Communicates decision to physicians, physician`s office staff, medical management staff and/or pharmacists.

• Researches, resolves and documents prior authorization outcomes in pharmacy system.

• Communicates selected prior authorization criteria, pharmacy benefit coverage and formulary alternatives to physicians, physician`s office staff, medical management staff and/or pharmacists.

• Escalates requests to Pharmacist when request requires extensive clinical review or denial.

• Researches, resolves and documents physician or client inquiries and grievances and provides verbal or written results to client, prescriber, provider and/or management.

• Performs other duties as required.

  Other Job Requirements

Responsibilities

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).Active Pharmacist license supersedes requirement for CPT and/or PTCB.Specialty or retail pharmacy industry experience, previous reimbursement experience, and/or working in a health plan/health care setting.In-depth knowledge of specialty injectable prescription drugs, disease states, health plan formulary management techniques, medical terminology and current diagnostic and reimbursement coding (J/Q codes, ICD-9, CMS 1500, etc.).Proficiency in Pharmacy computerized systems and software applications, as well as MS Office Product Suite.Excellent written and verbal communication skills.Ability to follow clinical criteria and instructions to approve prior authorization requests.Minimum of 6 months dispensing or retail experience required, or equivalent internal training will be substituted.Ability to identify and trouble-shoot problematic issues.

General Job Information

Title

Remote Clinical Pharmacy Technician, post training schedule of Monday through Friday 1:30-10:00pm Eastern time zone

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

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.

Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive.

Magellan is committed to providing equal employment opportunities to employees and applicants for employment without regard to race, color, creed, religion, sex, gender identity and expression, sexual orientation, marital status, age, national origin, ancestry, citizenship, physical or mental disability, disabled veteran or veteran of the Vietnam Era status, or any other factors protected by law.

Magellan is committed to meeting applicable Federal labor and employment law posting requirements by providing necessary posters in a format which is easily accessible and conspicuous to all applicants. Copies of applicable posters are accessible by clicking here (https://www.magellanhealth.com/media/760295/mg-federal-contractors-applicant-english.pdf) .

Warning: Employment Scam

It has come to our attention that a false representative is contacting potential candidates and offering them work at home positions with Magellan Health. -Interviews- are conducted completely through email and the false job offer includes the promise of a check to be issued to the candidate for the purposes of setting up a home office.

Please know that Magellan Health does not interview any candidate through email, nor do we issue checks to candidates to set up home offices. All of our available positions are posted on legitimate job boards and our recruitment team directly contacts candidates should there be a fit.

If you suspect you are being contacted by a false representative of Magellan Health, please call 410-953-2911

Job Detail

• Company:
  Magellan Health Services

Job Description

MUST be able to work 9:30am to 6:30pm Monday through Friday 3/21/22-5/13/22 followed by post training schedule of Monday, Tuesday, Thursday and Friday 11:30am to 10:00pm eastern standard time.

Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria.

• Determines appropriateness for medications. Communicates decision to physicians, physician`s office staff, medical management staff and/or pharmacists.

• Researches, resolves and documents prior authorization outcomes in pharmacy system.

• Communicates selected prior authorization criteria, pharmacy benefit coverage and formulary alternatives to physicians, physician`s office staff, medical management staff and/or pharmacists.

• Escalates requests to Pharmacist when request requires extensive clinical review or denial.

• Researches, resolves and documents physician or client inquiries and grievances and provides verbal or written results to client, prescriber, provider and/or management.

• Performs other duties as required.

  Other Job Requirements

Responsibilities

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).Active Pharmacist license supersedes requirement for CPT and/or PTCB.Specialty or retail pharmacy industry experience, previous reimbursement experience, and/or working in a health plan/health care setting.In-depth knowledge of specialty injectable prescription drugs, disease states, health plan formulary management techniques, medical terminology and current diagnostic and reimbursement coding (J/Q codes, ICD-9, CMS 1500, etc.).Proficiency in Pharmacy computerized systems and software applications, as well as MS Office Product Suite.Excellent written and verbal communication skills.Ability to follow clinical criteria and instructions to approve prior authorization requests.Minimum of 6 months dispensing or retail experience required, or equivalent internal training will be substituted.Ability to identify and trouble-shoot problematic issues.

General Job Information

Title

Remote Clinical Pharmacy Technician, post training schedule Mon, Tues, Thurs, Fri 11:30am to 10:00pm EST

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

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.

Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive.

Magellan is committed to providing equal employment opportunities to employees and applicants for employment without regard to race, color, creed, religion, sex, gender identity and expression, sexual orientation, marital status, age, national origin, ancestry, citizenship, physical or mental disability, disabled veteran or veteran of the Vietnam Era status, or any other factors protected by law.

Magellan is committed to meeting applicable Federal labor and employment law posting requirements by providing necessary posters in a format which is easily accessible and conspicuous to all applicants. Copies of applicable posters are accessible by clicking here (https://www.magellanhealth.com/media/760295/mg-federal-contractors-applicant-english.pdf) .

Warning: Employment Scam

It has come to our attention that a false representative is contacting potential candidates and offering them work at home positions with Magellan Health. -Interviews- are conducted completely through email and the false job offer includes the promise of a check to be issued to the candidate for the purposes of setting up a home office.

Please know that Magellan Health does not interview any candidate through email, nor do we issue checks to candidates to set up home offices. All of our available positions are posted on legitimate job boards and our recruitment team directly contacts candidates should there be a fit.

If you suspect you are being contacted by a false representative of Magellan Health, please call 410-953-2911

Job Detail

• Company:
  Magellan Health Services

Job Description

Candidate should have a strong learning design, training and facilitation background

The Learning Experience Project Manager is responsible for managing multiple complex, SBU-wide program(s) consisting of multiple projects and varying training deliverables. The Learning Experience Project Manager will ensure the successful integration of projects and adjusts project scope, and timing as needed, based on the needs of the business. This job requires extensive technical and project management experience as well as senior level facilitation skills and learning program experience.

• Establishes and scales best practices for project management for the Learning and Development (L&D) team, in partnership with L&D Management.

• Serves as a point of contact for the SBU Learning Community of Practice.

• Creates and executes project work plans and revises as appropriate to meet changing needs and requirements.

• Effectively applies Magellan's methodology and learning standards to assigned projects.

• Provides status reporting to stakeholders on a regular basis. Apprises L&D Management of issues requiring resolution in order to maintain progress in a timely basis.

• Resolves and/or escalates issues in a timely fashion.

• Conducts lessons learned to continually improve processes.

• Contributes to, implements, and maintains best practices and project management policies and guidelines.

• Coordinates the development of user manuals, training materials, and other resources as needed to enable successful implementation and utilization of the process or system to end users.

• Develops, manages and tracks team projects to ensure they stay on track and the team has adequate support and room to deliver.

• Creates and manages project plans to ensure deadlines are met, potential roadblocks and risks are anticipated, escalated and solved for, and quality and alignment across programs are delivered.

• Collaborates and communicates across the L&D team for shared visibility of timelines, communication, training, and success metrics.

• Defines the scope, goals, and deliverables of course development projects in collaboration with L&D leaders.

• Identifies and resolves project issues and implements improvement plans.

• Engages in virtual and/or in-person outreach to build, develop and grow partnerships vital to the success of the project.

• Working knowledge of concepts, practices, and procedures with project management, process development and execution.

• Applies adult learning principles and blended learning concepts in the planning of L&D projects.

• Facilitates in person and virtual instructor led training.

  Other Job Requirements

Responsibilities

Bachelor's degree plus 5+ years' project management or job-related experience in a medium to large-scale corporation.5+ years' training experienceMay consider additional years of experience in lieu of degree (4 additional years in lieu of degree or 2 additional years with an associate's degree).Requires extensive technical and project management experience as well as senior level facilitation skills and learning program experience.Strong working knowledge of Microsoft Product Suite, specifically Excel and Visio.Demonstrated understanding of instructional design, adult learning concepts, performance improvement, change management, and learning best practices.Experience with a Learning Management System is required.Experience with distance learning and learning technologies such as web-based training and authoring toolsKnowledge of project management practices and methodologies.Knowledge of process improvement methodologies.Ability to develop and maintain multiple project plans.Facilitation and interpersonal skills with the ability to work effectively with cross-functional teams. Proven ability to plan, organize, schedule, direct, control, and monitor project activities.

General Job Information

Title

Learning Experience Project Manager

Grade

24

Work Experience - Required

Project/Program Management, Training

Work Experience - Preferred

Education - Required

A Combination of Education and Work Experience May Be Considered., Bachelors

Education - Preferred

License and Certifications - Required

PMP - Project Management 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.

Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive.

Magellan is committed to providing equal employment opportunities to employees and applicants for employment without regard to race, color, creed, religion, sex, gender identity and expression, sexual orientation, marital status, age, national origin, ancestry, citizenship, physical or mental disability, disabled veteran or veteran of the Vietnam Era status, or any other factors protected by law.

Magellan is committed to meeting applicable Federal labor and employment law posting requirements by providing necessary posters in a format which is easily accessible and conspicuous to all applicants. Copies of applicable posters are accessible by clicking here (https://www.magellanhealth.com/media/760295/mg-federal-contractors-applicant-english.pdf) .

Warning: Employment Scam

It has come to our attention that a false representative is contacting potential candidates and offering them work at home positions with Magellan Health. -Interviews- are conducted completely through email and the false job offer includes the promise of a check to be issued to the candidate for the purposes of setting up a home office.

Please know that Magellan Health does not interview any candidate through email, nor do we issue checks to candidates to set up home offices. All of our available positions are posted on legitimate job boards and our recruitment team directly contacts candidates should there be a fit.

If you suspect you are being contacted by a false representative of Magellan Health, please call 410-953-2911

Job Detail

• Company:
  Magellan Health Services

Job Description

Interested in remote opportunity as a Principal IT Analyst (Financial Systems) while working for an innovative healthcare company where you can have an impact on people's lives? Apply today and come join us at Magellan Health as we lead the world toward a healthier future! For this Principal IT Analyst role, we are looking for someone with 7+ years experience and they must understand Financial systems - preferably Oracle SQL and Oracle Financial System.

This is a fully remote opportunity, allowing you to work from the comfort of your own home from anywhere inside the US.

This position will analyze, evaluate and design/redesign business, IT or operational processes using scientific approaches such as Critical Thinking, Lean Management, ITIL, Design Thinking and structured systems analysis and design. Provide leadership to more junior IT Analysts through all aspects of the software development cycles. Be a hands-on analyst who can define user stories and acceptance criteria, assist with problem solving, root cause analysis, trouble shooting and coaching of junior it analysts on the team and ensure that requirements and acceptance criteria satisfy business needs. Demonstrate a high level of expertise in the IT Analyst craft. Help the team work through impediments. Clear impediments and escalate issues when needed. Drive usability and quality of the software developed within the area. Help the team manage changes. Plan, prioritize and deliver the detail behind enhancements. Work on a variety of enterprise applications and problems. Develop relationships with senior stakeholders across partner teams, addressing concerns and removing roadblocks to drive projects forward.

• Ensure that requirements and acceptance criteria satisfy business needs.

• Deploy business requirements through reliable business system configuration updates to enterprise applications.

• Help the team work through impediments.

• Clear impediments and escalate issues when needed.

• Drive usability and quality of the software developed within the area.

• Helps the team manage changes.

• Plan, prioritize and deliver enhancements.

• Work on a variety of enterprise applications and problems.

• Develop relationships with senior stakeholders across partner teams, addressing concerns and removing roadblocks to drive projects forward.

• Analyze issues with focus on identifying root cause and prevention.

• Help the team arrive at innovative solutions.

• Other duties as assigned.

  Other Job Requirements

Responsibilities

7+ years related experience including a minimum of 3+ years of delivering requirements and testing in support of high quality, secure software in IT.Good presentation and communication skills. Highly collaborative.Ability to execute on strategies to solve complex and open-ended business problems.Lead prototyping of potential solutions.Perform implementation reviews.Lead support of resolution of technical challenges.Proactive, can-do attitude.Take responsibility for ensuring success of all implementation.Technically proficient and hands-on.Mastery of QA methodology and problem solving tools/techniques.Experience with applying Design Thinking Techniques.Critical Thinker.Strong presentation skills.Creativity and show initiative.

General Job Information

Title

Principal IT Analyst (Finance) - Fully Remote

Grade

28

Work Experience - Required

IT

Work Experience - Preferred

Education - Required

Education - Preferred

Bachelors - Computer and Information Science

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.

Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive.

Magellan is committed to providing equal employment opportunities to employees and applicants for employment without regard to race, color, creed, religion, sex, gender identity and expression, sexual orientation, marital status, age, national origin, ancestry, citizenship, physical or mental disability, disabled veteran or veteran of the Vietnam Era status, or any other factors protected by law.

Magellan is committed to meeting applicable Federal labor and employment law posting requirements by providing necessary posters in a format which is easily accessible and conspicuous to all applicants. Copies of applicable posters are accessible by clicking here (https://www.magellanhealth.com/media/760295/mg-federal-contractors-applicant-english.pdf) .

Warning: Employment Scam

It has come to our attention that a false representative is contacting potential candidates and offering them work at home positions with Magellan Health. -Interviews- are conducted completely through email and the false job offer includes the promise of a check to be issued to the candidate for the purposes of setting up a home office.

Please know that Magellan Health does not interview any candidate through email, nor do we issue checks to candidates to set up home offices. All of our available positions are posted on legitimate job boards and our recruitment team directly contacts candidates should there be a fit.

If you suspect you are being contacted by a false representative of Magellan Health, please call 410-953-2911

Job Detail

• Company:
  Magellan Health Services

Job Description

Facilitates department workflow by supporting clinical team with various care coordination workflows. Locates community services and other referral locations for enrollees, arranges access to care, supports communication with hospitals, and providers.

• Provides non-clinical support to workflows involving utilization management, case management, disease management, and health promotion.

• Troubleshoots when an appropriate provider, type of service, or appropriate level of care cannot be readily found.

• Has current knowledge or researches availability of community resources and services and link members to appropriate services. May assist in transitions in care for hospitalized patients and makes appropriate placements, if needed.

• Assumes responsibility for self-development and career progression.

• Proactively seeks and participates in ongoing training (formal and informal) in all aspects of the Care Worker role.

• Assists in the mentoring and training of new Care Workers.

• Remains responsible for updating self on ever changing information to ensure accuracy when dealing with members and providers.

• Coordinates and manages distribution of correspondence and materials to enrollees and providers.

• Participates in operational activities, including data collection, tracking, and analysis.

  Other Job Requirements

Responsibilities

Understanding of plan benefit structures, psychiatric/medical terminology, and local communication resources.For roles supporting the Chronic Pain Management SBU, understanding of Chronic Pain Management guidelines and workflows is also required.

General Job Information

Title

Care Worker

Grade

19

Work Experience - Required

Work Experience - Preferred

Clinical

Education - Required

Education - Preferred

Associates

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.

Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive.

Magellan is committed to providing equal employment opportunities to employees and applicants for employment without regard to race, color, creed, religion, sex, gender identity and expression, sexual orientation, marital status, age, national origin, ancestry, citizenship, physical or mental disability, disabled veteran or veteran of the Vietnam Era status, or any other factors protected by law.

Magellan is committed to meeting applicable Federal labor and employment law posting requirements by providing necessary posters in a format which is easily accessible and conspicuous to all applicants. Copies of applicable posters are accessible by clicking here (https://www.magellanhealth.com/media/760295/mg-federal-contractors-applicant-english.pdf) .

Warning: Employment Scam

It has come to our attention that a false representative is contacting potential candidates and offering them work at home positions with Magellan Health. -Interviews- are conducted completely through email and the false job offer includes the promise of a check to be issued to the candidate for the purposes of setting up a home office.

Please know that Magellan Health does not interview any candidate through email, nor do we issue checks to candidates to set up home offices. All of our available positions are posted on legitimate job boards and our recruitment team directly contacts candidates should there be a fit.

If you suspect you are being contacted by a false representative of Magellan Health, please call 410-953-2911

Job Detail

• Company:
  Magellan Health Services

Job Description

Serves as Lead ID card specialist and may operate as an autonomous service provider at a single-person site or as a Team Leader for sites with multiple ID card specialists. 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

ID Card Specialist Lead (Personnel Assistant III), NAVY ICA

Grade

WDNICAPAIII

Work Experience - Required

Work Experience - Preferred

Education - Required

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.

Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive.

Magellan is committed to providing equal employment opportunities to employees and applicants for employment without regard to race, color, creed, religion, sex, gender identity and expression, sexual orientation, marital status, age, national origin, ancestry, citizenship, physical or mental disability, disabled veteran or veteran of the Vietnam Era status, or any other factors protected by law.

Magellan is committed to meeting applicable Federal labor and employment law posting requirements by providing necessary posters in a format which is easily accessible and conspicuous to all applicants. Copies of applicable posters are accessible by clicking here (https://www.magellanhealth.com/media/760295/mg-federal-contractors-applicant-english.pdf) .

Warning: Employment Scam

It has come to our attention that a false representative is contacting potential candidates and offering them work at home positions with Magellan Health. -Interviews- are conducted completely through email and the false job offer includes the promise of a check to be issued to the candidate for the purposes of setting up a home office.

Please know that Magellan Health does not interview any candidate through email, nor do we issue checks to candidates to set up home offices. All of our available positions are posted on legitimate job boards and our recruitment team directly contacts candidates should there be a fit.

If you suspect you are being contacted by a false representative of Magellan Health, please call 410-953-2911

Job Detail

• Company:
  Magellan Health Services

Job Description

• Plan, develop, and ensure completion of all documentation elements in a timely manner, and communicate all changes in documentation to appropriate management staff. Types of documentation include, but not limited to, technical documentation, mapping of source and target data sets and data dictionaries.

• 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.

• Independently participate in requirements documentation, business systems configuration and defining/execution of

• acceptance criteria. Document issues and participate in their resolution.

• Work closely with development and business teams to understand business requirements.

• Translate business needs into high-level technical specifications and design. Identify gaps and ensure deployment of

• solutions.

• Support business-critical systems using mature IT and software engineering practices.

• Develop, deploy, and execute test strategies.

• Work with team to ensure the highest quality product delivery.

• Work closely with cross functional teams and across boundary organizations to gather requirements, define solutions,

• implement new tools and process, and provide ongoing support to these teams.

• Test applications and products at the user level, both manually and with automated tools.

• Develop deep understanding of the applications that he/she/they support.

• Communicating cross-functionally and across management levels in formal and informal settings.

• Track multiple test executions simultaneously and synthesize the results.

This position will analyze, evaluate and redesign business, IT or operational processes using scientific approaches such as Critical Thinking, Lean Management, ITIL, Design Thinking and structured systems analysis and design. Work quickly and independently while delivering high-quality outputs. Use strong organizational skills for tracking multiple deliverables simultaneously and be able to synthesize the results. Pay meticulous attention to detail; the ability to juggle many tasks in parallel without lowering the quality bar. Collaborate with Software Engineers to understand features and technical implementation and ensure highest quality product delivery. Develop deep understanding of the business/technical domain.

• Independently participate in requirements documentation, business systems configuration and defining/execution of acceptance criteria. Document issues and participate in their resolution.

• Work closely with development and business teams to understand business requirements.

• Translate business needs into high-level technical specifications and design. Identify gaps and ensure deployment of solutions.

• Support business-critical systems using mature IT and software engineering practices.

• Develop, deploy, and execute test strategies.

• Work with team to ensure the highest quality product delivery.

• Work closely with cross functional teams and across boundary organizations to gather requirements, define solutions, implement new tools and process, and provide ongoing support to these teams.

• Test applications and products at the user level, both manually and with automated tools.

• Develop deep understanding of the applications that he/she/they support.

• Communicating cross-functionally and across management levels in formal and informal settings.

• Track multiple test executions simultaneously and synthesize the results.

  Other Job Requirements

Responsibilities

3+ years related experience including developing requirements, designing and executing test cases in ITExperience with QA methodology and problem solving techniques/tools.Detail-oriented person who is passionate about quality and is enthusiastic about the new technology offered to customers.Demonstrated software testing experience.Excellent written and oral communication skills.Meticulous attention to detail; the ability to juggle several tasks in parallel without lowering your quality bar.Experience with analytical programming languages such as SQL.Ability to thrive in ambiguity and rapid change.Experience with process flow diagrams.Experience with applying Agile Methods.

General Job Information

Title

Senior IT Analyst - Remote

Grade

25

Work Experience - Required

IT

Work Experience - Preferred

Education - Required

A Combination of Education and Work Experience May Be Considered., Bachelors - Computer and Information Science

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.

Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive.

Magellan is committed to providing equal employment opportunities to employees and applicants for employment without regard to race, color, creed, religion, sex, gender identity and expression, sexual orientation, marital status, age, national origin, ancestry, citizenship, physical or mental disability, disabled veteran or veteran of the Vietnam Era status, or any other factors protected by law.

Magellan is committed to meeting applicable Federal labor and employment law posting requirements by providing necessary posters in a format which is easily accessible and conspicuous to all applicants. Copies of applicable posters are accessible by clicking here (https://www.magellanhealth.com/media/760295/mg-federal-contractors-applicant-english.pdf) .

Warning: Employment Scam

It has come to our attention that a false representative is contacting potential candidates and offering them work at home positions with Magellan Health. -Interviews- are conducted completely through email and the false job offer includes the promise of a check to be issued to the candidate for the purposes of setting up a home office.

Please know that Magellan Health does not interview any candidate through email, nor do we issue checks to candidates to set up home offices. All of our available positions are posted on legitimate job boards and our recruitment team directly contacts candidates should there be a fit.

If you suspect you are being contacted by a false representative of Magellan Health, please call 410-953-2911

Job Detail

• Company:
  Magellan Health Services

Job Description

This position will analyze, evaluate and redesign business, IT or operational processes using scientific approaches such as Critical Thinking, Lean Management, ITIL, Design Thinking and structured systems analysis and design. Work quickly and independently while delivering high-quality outputs. Use strong organizational skills for tracking multiple deliverables simultaneously and be able to synthesize the results. Pay meticulous attention to detail; the ability to juggle many tasks in parallel without lowering the quality bar. Collaborate with Software Engineers to understand features and technical implementation and ensure highest quality product delivery. Develop deep understanding of the business/technical domain.

• Independently participate in requirements documentation, business systems configuration and defining/execution of acceptance criteria. Document issues and participate in their resolution.

• Work closely with development and business teams to understand business requirements.

• Translate business needs into high-level technical specifications and design. Identify gaps and ensure deployment of solutions.

• Support business-critical systems using mature IT and software engineering practices.

• Develop, deploy, and execute test strategies.

• Work with team to ensure the highest quality product delivery.

• Work closely with cross functional teams and across boundary organizations to gather requirements, define solutions, implement new tools and process, and provide ongoing support to these teams.

• Test applications and products at the user level, both manually and with automated tools.

• Develop deep understanding of the applications that he/she/they support.

• Communicating cross-functionally and across management levels in formal and informal settings.

• Track multiple test executions simultaneously and synthesize the results.

  Other Job Requirements

Responsibilities

3+ years related experience including developing requirements, designing and executing test cases in ITExperience with QA methodology and problem solving techniques/tools.Detail-oriented person who is passionate about quality and is enthusiastic about the new technology offered to customers.Demonstrated software testing experience.Excellent written and oral communication skills.Meticulous attention to detail; the ability to juggle several tasks in parallel without lowering your quality bar.Experience with analytical programming languages such as SQL.Ability to thrive in ambiguity and rapid change.Experience with process flow diagrams.Experience with applying Agile Methods.

General Job Information

Title

Senior IT Business Analyst - Remote

Grade

25

Work Experience - Required

IT

Work Experience - Preferred

Education - Required

A Combination of Education and Work Experience May Be Considered., Bachelors - Computer and Information Science

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.

Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive.

Magellan is committed to providing equal employment opportunities to employees and applicants for employment without regard to race, color, creed, religion, sex, gender identity and expression, sexual orientation, marital status, age, national origin, ancestry, citizenship, physical or mental disability, disabled veteran or veteran of the Vietnam Era status, or any other factors protected by law.

Magellan is committed to meeting applicable Federal labor and employment law posting requirements by providing necessary posters in a format which is easily accessible and conspicuous to all applicants. Copies of applicable posters are accessible by clicking here (https://www.magellanhealth.com/media/760295/mg-federal-contractors-applicant-english.pdf) .

Warning: Employment Scam

It has come to our attention that a false representative is contacting potential candidates and offering them work at home positions with Magellan Health. -Interviews- are conducted completely through email and the false job offer includes the promise of a check to be issued to the candidate for the purposes of setting up a home office.

Please know that Magellan Health does not interview any candidate through email, nor do we issue checks to candidates to set up home offices. All of our available positions are posted on legitimate job boards and our recruitment team directly contacts candidates should there be a fit.

If you suspect you are being contacted by a false representative of Magellan Health, please call 410-953-2911

Job Detail

• Company:
  Magellan Health Services

Job Description

Provides 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.

• 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.

• Assist efforts to continuously improve by assuming responsibility for identifying and bringing to the attention of responsible entities operations problems and/or inefficiencies.

• Assist in the mentoring and training of new staff.

• Assume full responsibility for self-development and career progression; proactively seek and participate in ongoing trainings (formal and informal).

• Comprehensively assembles and enters patient information into the appropriate delivery system to initiate the EAP, Care and Utilization management programs.

• Demonstrate 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.

• Lead or participate 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's 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 bilingual.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. 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 MediCal Hindi

Grade

17

Work Experience - Required

Customer Service

Work Experience - Preferred

Education - Required

GED, High School

Education - Preferred

Associates

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.

Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive.

Magellan is committed to providing equal employment opportunities to employees and applicants for employment without regard to race, color, creed, religion, sex, gender identity and expression, sexual orientation, marital status, age, national origin, ancestry, citizenship, physical or mental disability, disabled veteran or veteran of the Vietnam Era status, or any other factors protected by law.

Magellan is committed to meeting applicable Federal labor and employment law posting requirements by providing necessary posters in a format which is easily accessible and conspicuous to all applicants. Copies of applicable posters are accessible by clicking here (https://www.magellanhealth.com/media/760295/mg-federal-contractors-applicant-english.pdf) .

Warning: Employment Scam

It has come to our attention that a false representative is contacting potential candidates and offering them work at home positions with Magellan Health. -Interviews- are conducted completely through email and the false job offer includes the promise of a check to be issued to the candidate for the purposes of setting up a home office.

Please know that Magellan Health does not interview any candidate through email, nor do we issue checks to candidates to set up home offices. All of our available positions are posted on legitimate job boards and our recruitment team directly contacts candidates should there be a fit.

If you suspect you are being contacted by a false representative of Magellan Health, please call 410-953-2911

Job Detail

• Company:
  Magellan Health Services