Company Detail

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

Job Description

This position provides administrative oversight and management of a site or line of business Prior Authorization (PA)/Utilization Management (UM) department responsible for managing the delivery of member and provider services. This position plays a key role in initiatives critical to Magellan in achieving revenue goals and operational objectives. The position requires communication and teamwork across internal departments (account management, implementations, IT, quality, specialty pharmacy), in order to achieve objectives and SLAs. This position is also accountable for hiring, developing, mentoring, training and retaining staff.

• Manages the pre-authorization process and customer service requirements to ensure compliance, quality and customer service level agreements are met.

• Manages and coordinates the activities of the team to efficiently manage the output of assigned tasks.

• Monitors the performance of team members by means of reports and observation.

• Assumes accountability for team conduct and productivity.

• Monitors individual team member's attendance and reliability patterns.

• Administers performance improvement or corrective action plans when needed.

• Coaches, mentors and develops Team Leaders/Supervisors and staff with a focus on quality and accuracy of service.

• Works across divisional lines to ensure staff is properly trained and issues needing resolution are addressed timely.

• Creates a culture of support, accountability and continuous improvement.

• In collaboration with the Training Department, plans and develops training programs for department staff.

• As the end user and system expert, proactively suggests changes/updates to the prior authorization application that ensures maximum protocol adherence, documented medication savings, and increased health plan customer satisfaction.

• Possesses financial responsibility for meeting administrative budgets and the creation of innovative efficiencies.

• Assists divisional management with the implementation of improvement initiatives and new business implementations.

• Partners with Account Management and business clients to improve communications and address issues that may arise.

• For Managers assigned to Clinical Programs: Assists in completing calls for clinical, specialty clinical, account management and all other programs carried out by the clinical department. Assists in building out/organizing program protocol. Ensure all organizational documents are generated and cataloged according to internal protocols.

  Other Job Requirements

Responsibilities

Excellent written and verbal communication skills.Working knowledge of Microsoft Office Product Suite. Comfortable and willing to learn new technology and software applications.Strong problem solving skills.3+ years' direct supervisory experience.For positions supporting Medicare Part B, requires 2+ years of experience in Medicare Part B.

General Job Information

Title

Manager, Clinical Pharmacy Operations MediCal

Grade

25

Work Experience - Required

Customer Service, Pharmacy, Supervisory

Work Experience - Preferred

Education - Required

Education - Preferred

Bachelors

License and Certifications - Required

License and Certifications - Preferred

CPT/ExCPT/LPT/PTCB/RPT, Pharmacy Technician, State Requirements - 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

Provides services in support of the advocacy, intervention, prevention, education and training to address domestic violence under the Army's Family Advocacy Program (FAP). This position supports the Army's Victim Advocacy Program (VAP) which provides comprehensive services 24 hours a day, 7 days per week, to assist and advocate for victims of domestic abuse and to ensure a victim's easy transition to community resources. The victim advocate (VA) serves Soldiers and Army Families living on and off the installation in accordance with the program protocol.

• Provides crisis intervention and comprehensive services to include emotional support, arrangement of transportation; accompany victims to medical, legal and/or law enforcement appointments (when requested), assist in securing protective orders, emergency food and/or shelter and information benefits.

• Works directly with victims to ensure that expressed needs are advocated and presented to personnel at intervening agencies.

• Assesses imminent risks for health and/or safety of the victim and make referrals as appropriate.

• Assists victims with navigating the system to obtain the services desired and refer victims to the appropriate services for continued care.

• Ensures victims of domestic abuse receive sensitive, confidential and immediate comprehensive care and treatment needed to restore health and well-being.

• Performs initial screening, non- clinical risk and lethality assessment and safety planning with victims of domestic abuse.

• Assists victims in developing safety plans, conduct a lethality assessment, and provide emotional support, crisis intervention, prevention awareness and education to victims.

• Liaisons with the installation Family Advocacy Program Manager (FAPM) to ensure that comprehensive victim services and training are provided through a coordinated community response to domestic abuse victims, , Family Members, Soldiers and Civilians authorized to receive services at a Military Treatment Facility.

• Provides crisis intervention and a warm hand off to community resources for victims who are not eligible for services through a Military Treatment Facility.

• Provides information on victim rights, services and resources available on and/or off the installation.

• Coordinates with the (FAPM) to develop procedures that ensure victims of domestic abuse receive timely and appropriate information.

• When contacted by a victim of domestic abuse, make contact either telephonically within 20 minutes or face to face within 60 minutes (when requested) by the victim.

• Explains FAP disclosure and reporting options during the initial contact to ensure that the victim makes informed decisions about disclosing information regarding the abuse.

• Ensures that first responders, (Emergency Medical Services and or law enforcement etc.) are contacted immediately during crisis situations where there is imminent harm to the victim, their children or program staff..

• Operates within established guidelines of the FAP and the Victim Advocacy Program, AR 608-18.

• Conducts domestic abuse training and awareness programs to educate Soldiers and Family members and Civilians.

• Understanding of Problematic Sexual Behavior- Child and Youth (PSB-CY)

• Guide client families through the investigative process, encourage their participation in the process, and help them understand their rights as a victim of a crime.

• Formulate appropriate intervention strategies to improve a family's coping skills during a child abuse case investigation and prosecution process.

• Identify and make every attempt to meet the needs of children and families who may be in crisis

• Educate non-offending caregivers about the dynamics and possible long-term consequences of child abuse

• Assess family needs and encourage non-offending caregivers to participate in recommended services and counseling.

• Provide information and assistance with completing Crime Victims'' Compensation applications.

• Serve as a liaison between the family and multidisciplinary team members as needed.

• Assist multidisciplinary team members in identifying client needs and providing recommendations.

• Represent the child and family's best interest at multidisciplinary team case review meetings.

• Accompany non-offending caregivers to court or other appointments, when requested.

• Participate in relevant community awareness, campaigns and prevention events.

• Maintain ongoing case management, all data entry must be completed within three business days.

• Ensure daily contact with a victim while in crisis and no

• When a victim departs the servicing area, case shall be transferred as appropriate, when advocacy services are completed, the case will be closed as appropriate, with concurrence from the FAPM.

• Part Time Positions: part time positions vary in hours from 12 - 35 hours per week. Flexible schedule is required for this position, as you will be asked to work primarily nights, weekends, and some hours during the day, depending on the needs of the installation. More information will be provided if you are selected for the interview process.

  Other Job Requirements

Responsibilities

Bachelor"s Degree from an accredited school in social/work, psychology, marriage, family, and child counseling, counseling or behavioral science, education, community health or public health.Two years" experience working with victims of domestic abuse/sexual assault violence or victim advocacy services. Working knowledge of Family violence dynamics, safety planning, risk assessments, local community resources, and federal and state laws pertaining to domestic abuse or sexual assault, Family law and the Victim Rights Bill. Possess ability to intervene in crisis situations, using sound professional judgment, ethical practice, and common sense. Ability to work independently to assess risk, develop, implement, and evaluate safety and intervention plans to meet victim needs.Demonstrated understanding, sensitivity, and empathy for victims. Possess the ability to develop trusting helping relationships. Possess the ability to work effectively with individuals and families from diverse racial, ethnic, and socioeconomic backgrounds. Ability to work cooperatively with military and civilian medical, social service, law enforcement, and legal personnel on behalf of victims.Must possess and maintain a valid, unrestricted motor vehicle license.Must possess transportation to transport victim in crisis (non-emergent) situations as a last resort. Must be able to provide on-call 24 hours/7 days per week victim advocacy services.

General Job Information

Title

Part Time Victim Advocate, FASS

Grade

WDNFASSVA

Work Experience - Required

Victim Advocacy

Work Experience - Preferred

Military

Education - Required

Bachelors - Counseling

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

Primary responsibility to provide the full breadth of MFLC (Military Family Life Counseling) counseling services to military service members and their families at military installations. Services include non- medical, short-term, walk-around counseling, training/health and wellness presentations, provision of health fairs, and consultation to installation command regarding behavioral health issues. Works closely with the installation and military branch Points of Contact (POC) to assure that the program is provided within scope and meets the needs of the installation.

• Provides non-medical, short- term, solution focused, walk-around counseling directly to service and family members. Services include assessment, brief counseling and consultation, action planning, referral to resources (assuring linkage as appropriate), and follow-up as indicated.

• Delivers training and health and wellness presentations, participates in health fairs and other base/installation activities as requested/ directed.

• Enters counselor activity data on a daily basis through smart phone or web application, to ensure that reporting is accurate from assigned installation, while maintaining client / service member confidentiality.

• Creates a presence on the installation in which the service and family members feel comfortable approaching the counselor and recognize the program to be confidential. Establishes and maintains working relationships with community resources and provides appropriate linkages for service members and their families. Partners with POC to provide MFLC services in a manner that addresses the needs of the installation. Develops an effective and professional working relationship with the installation POC.

• Provides MFLC response to critical incidents, surge and on demand events, and special requests as directed by the POC and approved by the government customer. Counselor will flex schedule to respond to urgent requests as needed.

• Manages duty- to-warn and restricted reporting situations according to Department of Defense (DoD) protocol and staffs the cases with Regional Supervisor/Regional Director.

• Communicates with Regional Supervisors and participates in regular individual and group supervision, sharing information regarding trends and issues on the installations to which the counselor is assigned.

• Responds to critical incidents and special requests as directed by the POC and approved by the government customer. Will flex schedule to respond to urgent requests as needed.

• Participates in regular in-services/training, quality improvement committees or other contract activities as assigned/ appropriate.

• Learns skills and requirements necessary for licensure, directly participate with supervision in training program and applies supervisor guidance on the job.

• Completes records and other documentation in compliance with program licensing regulations and standards

• Stays abreast of current theory and counseling modalities by reading professional journals, attending conferences, clinic seminars, teleconferences and materials distributed by staff.

• Participates as required in staff development programs

• Ensures all state licensing board requirements necessary for independent licensure are obtained within the 2-year period to include any additional hours, experience, training, and supervision beyond what the scope of the position provides.

  Other Job Requirements

Responsibilities

Master's degree from an accredited graduate program in a relevant field of study to include, but not limited to, a mental health related field such as social work, psychology, marriage/family therapy, or counseling.Provisional licenses and working towards a valid unrestricted counseling license from a State, District of Columbia, US Territory or Commonwealth that grants authority to provide counseling services as an independent practitioner.Must obtain an independent clinical license within two years of hire date.Requires ability to engage and communicate with military members or children as assigned, in order to accomplish job functions, and to respond quickly to emergent situations in any physical location on a military installation and/or within a school setting, which includes the need to traverse short and/or long distances within the base to both indoor and outdoor locations, to maneuver through rugged, outdoor or uneven locations (e.g., steep inclines, stairs, grass), and work in outdoor weather and other military base conditions.May require travel to locations outside of a military base in a variety of physical environments.Due to the nature of working on military installations or related work-sites, counselors may need to comply with various site specific requirements to work at designated locations. For example, for some assignments, counselors will need to have certain immunizations or vaccinations and provide record of receipt.Ability to prove US Citizenship and must be fluent in English.Understanding, sensitivity and empathy for service members and their families. Ability to develop trusting, helping relationships. Ability to work with individuals and families from diverse racial, ethnic and socioeconomic backgrounds.Must pass a National Agency Check and Inquiries (NACI) Clearance and an Installation Records Check (IRC), Criminal Background Check and FBI Fingerprints Check.Should have a positive attitude with a willingness to learn and collaborate within a team to provide clients with best care possible.Ability to work alongside others to provide a combination of treatment methods and other creative interventions.Possess the ability to independently research, track, adjust, and complete tasks related to independent licensure completion without direct supervision.Vehicle Operator's license requirement: Unless specifically waived by the FEDSIM COR, all contractor personnel providing counseling support at Government locations shall possess a valid U.S. state vehicle operator's license. As a condition for employment under this contract, contractor personnel may be required to pass all tests for and obtain a U.S. military vehicle operator's permit for commercial sedans and similar, for use at Temporary Duty (TDY) locations, if required.

General Job Information

Title

Military and Family Life Counselor, Tier 1 (Provisional License)

Grade

MFLC Tier 1

Work Experience - Required

Work Experience - Preferred

Clinical

Education - Required

Masters - Counseling, Masters - Social Work

Education - Preferred

License and Certifications - Required

DL - Driver License, Valid In State - Other

License and Certifications - Preferred

Current licensure required for this position that meets State, Commonwealth or customer-specific requirements - Care Mgmt, Must be an independently licensed behavioral health clinician - Care Mgmt

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

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

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 Armenian

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

Job Description

Provides direct support to organizations and their employees through the delivery of assessment, consultation, education and triage services. Uses knowledge of federal regulations to assist organizations in their appropriate handling of employee concerns and problems. Consults with employees and organizations on variety of workplace and work based issues. Provides clinical expertise in order to restore employees with diminished performance to healthy functioning.

• Provides employee consultation related to specific personal problems and concerns. Provides crisis assessment and intervention as needed.

• Completes clinical and administrative documentation and required forms in a clear and concise manner. Manages caseload and other tasks to meet both qualitative and quantitative performance expectations.

• Provides behavioral health assessments, accurate clinical diagnoses, and referral to appropriate level of care. Provides expert consultation to employees and/or supervisors on a variety of workplace and work based issues. Provides information and referral to community resources as appropriate. Provides clinical consultation/staffing in absence of EAP Manager.

• Participates in activities as requested that help improve SBU and/or client performance, excellence and culture.

• Supports team members and participate in team activities to help build a high-performance team.

• Demonstrates flexibility in areas such as job duties and schedule to aid in better serving its members and help Magellan achieve its business and operational goals.

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

  Other Job Requirements

Responsibilities

Minimum of 5 years of clinical experience after receiving the graduate degree.Clinical training must include instruction on chemical dependency, mental health and brief therapy.Must have understanding of workplace issues, how businesses function and a fundamental understanding of employee/employer relationships.Must be capable of acquiring an understanding of EEO rules, ADA in the workplace, FMLA, and Drug Free Workplace Requirements.Must be able to provide accurate client assessment including level of risk, substance abuse and dependency, job performance issues and refer to appropriate level of care.Competent in crisis intervention.Demonstrates knowledge and expertise in solution-focused, brief therapy in outpatient setting.Strong customer service skills required.Must be able to sensitively, compassionately respond to callers. Excellent listening skills vital.Interacts effectively at all levels both within the company and with external customers.Analyzes and presents issues in a clear, concise, persuasive manner, both orally and in writing. Uses time to manage caseload and documentation effectively.Meets productivity targets and quality management expectations.Develops effective working relationships with peers within and across organizational lines.Effectively resolves individual conflicts. Supports department mission and keeps management informed of team issues.Takes responsibility for own development and stays current on skills and techniques needed to perform job.Adjusts well to new situations and changing priorities.Comfortable with ambiguity and stress while handling a variety of assignments.Maintains a positive, achievement-oriented attitude and consistent in accomplishing expected objectives.

General Job Information

Title

EAP Counselor

Grade

23

Work Experience - Required

Clinical, Employee Assistance Program (EAP)

Work Experience - Preferred

Education - Required

Masters - Behavioral Health

Education - Preferred

License and Certifications - Required

Current licensure required for this position that meets State, Commonwealth or customer-specific requirements - Care Mgmt, LCSW-C - Licensed Certified Social Worker - Clinical - Care Mgmt, LCSW - Licensed Clinical Social Worker - Care Mgmt, LMHC - Licensed Mental Health Counselor - Care Mgmt, LPCC - Licensed Professional Clinical Counselor - Care Mgmt, LPC - Licensed Professional Counselor - Care Mgmt, Must be an independently licensed behavioral health clinician - Care Mgmt

License and Certifications - Preferred

CEAP - Certified Employee Assistance Professional - Care Mgmt

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

Community Healthcare workers dedicated to Montgomery members to provide member support on identifying and connecting to resources to meet their social determinants of needs, as well as behavioral and physical health care.

Provides ongoing, community-based support for an assigned caseload of health plan enrollees to improve access to care and care coordination. Establishes a relationship with the enrollee, the care coordination team, and providers. Conducts new enrollee outreach and orientation, arranges appointments and transportation as needed. Assists the enrollee in learning to navigate the health care delivery system, community resources, transportation, and effectively use health plan benefits.

• Conducts outreach and orientation for new enrollees. Gathers information needed to ensure continuity of care and permission to share information.

• Administers Health and Wellness Questionnaire.

• Seeks connection by working with the Peer Support Specialist and leveraging community services, care providers, family members, schools, etc.

• Assists enrollees in accessing care and ensures care is received. Helps members, as needed, in selecting providers, making appointments, and planning transportation.

• Contacts enrollee or provider to ensure appointments have occurred. Assists in transitions of care to and from alternative levels of care or settings.

• Makes follow up care arrangements and ensures post-hospital care is delivered as planned.

• Meets with enrollee regularly (as determined by individual risks) in order to monitor progress according to the Care Coordination Plan.

• Reminds enrollee of self-management tools and crisis support. Informs and engages the Care Coordination Team if enrollee has difficulty adhering to the care coordination plan or adhering to treatment and needs additional support.

• Works with enrollee and family/supports to engage in socialization, work or volunteer related activities, or access community resources and services.

• Maintains up to date documentation in the Care Coordination Plan and other Health Services tools.

• Prepares information for Care Coordination Team meetings and as requested, for shared treatment planning sessions.

  Other Job Requirements

Responsibilities

Experience in community service, health care or social services and/or community-based or home health care experience required, Experience with individuals who have severe mental illness or chronic medical conditions.

General Job Information

Title

Health Guide- Community Healthcare Worker

Grade

19

Work Experience - Required

Clinical

Work Experience - Preferred

Managed Healthcare

Education - Required

Education - Preferred

Associates, Bachelors

License and Certifications - Required

DL - Driver License, Valid In State - Other

License and Certifications - Preferred

LPN - Licensed Practical Nurse - Care Mgmt

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 in support of the United States Military Academy at West Point . Candidates must be local to West Point or willing to relocate to become local and be licensed at the independent level in the state of New York as a Mental Health Counselor (LMHC), Therapist (LMFT), or Social Worker (LCSW).

Provides the full breadth of MFLC consultation and counseling services to the command structure and military service members and their families as an embedded counselor assigned to a dedicated military unit. Responsible for providing MFLC services including non-medical, short term, walk around counseling, training/health and wellness presentations, and consultation to the brigade/regiments command regarding behavioral health issues with a unique understanding of the particular military unit, cultural and mission.

• Provides non-medical, short-term, solution focused, walk-around counseling directly to service and family members of a dedicated military unit (brigade, wing or regiment) as an embedded counselor. Services include assessment, brief counseling and consultation, action planning, referral to resources (assuring linkage as appropriate), and follow-up as indicated. Delivers training and health and wellness presentations and activities as requested/ directed.

• Enters counselor activity data on a daily basis through smart phone or web application to assure that reporting is accurate from assigned installation, while maintaining client / service member confidentiality.

• Cultivates and maintains direct relationships with commanders and personnel within the assigned military unit, utilizing relationship management skills and recognizing the unique structure and mission of the assigned military unit. Responsible for development of an effective and professional working relationship with the installation POC (Point of Contact), command, and the command POC.

• Creates a presence within the brigade/regiment in which the service and family members feel comfortable approaching the counselor, recognizing the program to be confidential. Establish and maintain working relationships with community resources and provide appropriate linkages for service members and their families. Partners with POC to provide MFLC services in a manner that addresses the needs of the brigade/regiment.

• Provides MFLC response to critical incidents, surge, and special requests as directed by the POC and approved by the Office of Secretary of Defense (OSD) program manager. Counselor will flex schedule to respond to urgent requests as needed.

• Manages duty to warn and restricted reporting situations according to Department of Defense (DoD) protocol and staffs the cases with Regional Supervisor/Regional Director.

• Communicates with Regional Supervisors and participates in regular individual and group supervision, sharing information regarding trends and issues on the installations to which the counselor is assigned.

• Participates in regular in-services/training, Quality Improvement committees or other contract activities as assigned/appropriate.

  Other Job Requirements

Responsibilities

Master's Degree from an accredited Graduate Program in a Mental Health related field.Valid unrestricted counseling license from a State, District of Columbia, US Territory or Commonwealth that grants authority to provide counseling services as an independent practitioner.For assignments in the 50 states, counselors shall be licensed or certified in the state in which the client is receiving services.A minimum two years of post licensure counseling experience.Requires ability to engage and communicate with military members or children as assigned, in order to accomplish job functions, and to respond quickly to emergent situations in any physical location on a military installation and/or within a school setting, which includes the need to traverse short and/or long distances within the base to both indoor and outdoor locations, to maneuver through rugged, outdoor or uneven locations (e.g., steep inclines, stairs, grass), and work in outdoor weather and other military base conditions. May require travel to locations outside of a military base in a variety of physical environments. Due to the nature of working on military installations or related worksites, counselors may need to comply with various site specific requirements to work at designated locations. For example, for some assignments, counselors will need to have certain immunizations or vaccinations and provide record of receipt.Ability to prove US Citizenship and must speak fluent English.Understanding, sensitivity and empathy for service members and their families. Ability to develop trusting, helping relationships. Ability to work effectively with individuals and families from diverse racial, ethnic, and socioeconomic backgrounds.Pass a National Agency Check and Inquiries (NACI) Clearance and an Installation Records Check (IRC), Criminal History Background Check and FBI Fingerprints Check.Some units require a secret level clearance in addition to the previously stated requirements.Vehicle Operator's License Requirement: Unless specifically waived by the FEDSIM COR, all contractor personnel providing counseling support at Government locations shall possess a valid U.S. state vehicle operator's license. As a condition for employment under this contract, contractor personnel may be required to pass all tests for and obtain a U.S. military vehicle operator's permit for commercial sedans and similar, for use at Temporary Duty (TDY) locations, if required.

General Job Information

Title

Military and Family Life Counselor - Embedded

Grade

MFLC Tier 3

Work Experience - Required

Clinical

Work Experience - Preferred

Education - Required

Masters - Behavioral Health, Masters - Social Work

Education - Preferred

License and Certifications - Required

Current licensure required for this position that meets State, Commonwealth or customer-specific requirements - Care Mgmt, DL - Driver License, Valid In State - Other, Must be an independently licensed behavioral health clinician - Care Mgmt

License and Certifications - Preferred

Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.

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

Function as the Regional Coordinator (RC) to facilitate the regular placement of Wounded, Ill, or Injured (WII) Service members (SMs) into internships with participating federal agencies and provide WII SMs educational options and employment opportunities at the location and in areas of interest.

• Aligns with OSD (P&R) in implementing regional and local practices. Adhere to program management protocols received from HQ Program Manager.

• Maintains program operations regionally and locally.

• Maintains and supports strategic partnerships at the regional and local levels.

• Finds and develops internship and employment opportunities, including increased access to career placement assistance.

• Identifies career opportunities with employing organizations to determine qualifications and requirements.

• Finds and develops opportunities for internships, education and training, including assistance in identifying and completing academic or vocational education.

• Conducts outreach to regional and local Veterans Affairs, Federal Government, the private sector and educational institutions, ensuring a foundation for seamless WII SM transition.

• Initiates, develops, and sustains relationships demonstrating community involvement.

• Supports Military Services in the Region in their efforts to assist their WII SMs.

• Develops and sustains relationships demonstrating community engagement.

• Works with WII SMs to identify needs, support requirements, career interests, and education/training requirements.

• Collaborates with the employing institution to facilitate communications and candidate screening for WII SMs.

• Develops individualized development plans for WII SMs and identify training and certification opportunities to fill gaps in skills.

• Assists the Military Services to ensure the WII SM has an advocate and mentor through the end-to-end employment process.

• Captures and submits performance standards and metrics, to include reporting templates and processes; respond to contract performance work statement requirements.

  Other Job Requirements

Responsibilities

Military experience as a Senior NCO or Company Grade Officer or above with technical assignments that are related to counseling, case management, claims, benefits processing, supervision/management, or spouse of the preceding.Excellent presentation skills.Ability to communicate ideas and processes thoroughly and clearly to people at various levels of education and computer competency.Excellent organizational and time management skills.Proficiency with Microsoft Office suite, including Word, Excel, and PowerPoint.Ability to work independently.Superb communication/collaboration skills.Ability to act professionally, confidently, and positively communicate with employees and managers at all levels.Ability to foster an atmosphere of teamwork with others.Ability to present ideas, concepts, issues, concerns, and questions in a well thought out, positive, and professional manner to employees.Excellent presentation skills.Active listening and coaching skills.Operates with minimal supervision.Must be available to travel as required.The ability to work at an accelerated pace.

General Job Information

Title

Regional Coordinator OWF/E2I, WCP

Grade

23

Work Experience - Required

Military

Work Experience - Preferred

Education - Required

High School

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

Serves as a member of the Service Operations Management Team. Leads and grows the performance of a team of customer service agents while supporting and enhancing customer experiences and business objectives. Responsible for day-to-day tactical activities, performance trending, performance managing/coaching/developing agents and time management. Responsible for the delivery of superior customer service by maximizing employee performance and ensuring calls are answered effectively and efficiently by supervising incoming calls, resolving escalated calls, assisting agents with any client related questions, ensuring agents adherence to schedules and ensuring compliance to policies and procedures. Motivates agents to peak performance through positive coaching, constructive feedback and incentives, demonstrates a commitment to the company`s mission and vision, and supports activities that strengthen the client relationship and grow the organization.

• Drives the daily performance of a team of customer service agents ensuring SLAs and other business targets are met and exceeded.

• Collects and provides timely, productive and measurable feedback to ensure recognition, process changes and development opportunities are maximized.

• Oversees the team`s annual goal setting process, performance evaluations and performance improvement plans.

• Supports agents, business and brand initiatives, especially as related to achieving outstanding client experiences, including engaged daily floor support, escalated customer resolution and engagement in training and support areas as needed.

• Remains alert to conversations on the floor, monitoring agents for quality and training purposes.

• Reviews new and updated accounts with Agents (one-on-one).

• Ensures agents compliance with policies and procedures.

• Provides direction to agents on achieving departmental standards while encouraging and motivating them in promoting customer loyalty, employee recognition, and revenue generation.

• Monitors call traffic and makes adjustments based on call center traffic patterns.

• Produces monthly team report detailing team activity, trend analysis, goals/objective status and special projects.

• Actively participates in process / project conversations, emails and activities that will improve effectiveness/experience for client, agents, leadership, brands or partner departments

• Displays ownership and accountability for the customer experience, employee relations, core business metric targets/contributing factors and understanding of the organizations policies and procedures.

• Maintains reliability and flexibility to ensure team and business needs are appropriately supported.

• Delegates work to agents as needed.

• Proactively addresses call center concerns and identifies areas of opportunity.

• Handles system emergencies with direction from IT department and/or appropriate vendor.

• Assists with task assignments in the Manager's absence.

• Performs other related duties and special projects as requested.

  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).Minimum of 3 years of experience in a high volume call center and Pharmacy Benefit Management (PBM) experience required.For positions supporting Medicare Part B, requires 2+ years of experience in Medicare Part B.

General Job Information

Title

Remote Call Center Supervisor, Clinical Pharmacy

Grade

22

Work Experience - Required

Customer Service, PBM (Pharmacy Benefit Management)

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

The Website Content Coordinator is responsible for writing, editing and proofreading site content while maintaining site standards, relevance and currency. The Website Content Coordinator is also responsible for working closely with government, industry, nonprofit and educational partners to provide valuable and up-to-date online resources for website users. The Website Content Coordinator will work closely with management, technical, functional and communications members of the organization. Strong communication skills are needed for coordinating stakeholder engagement and outreach activities; continuous attention to detail is required for this high visibility website.

• Creates and develops content for organization's web presence.

• Works with in-house research team and coordinate partner participation.

• Maintains a consistent look and feel throughout all web properties.

• Reports successes and issues concisely to senior managers.

• Coordinates web projects across program elements.

• Supports SharePoint (and other collaborative tools) solutions, web parts, web services, widgets using industry best practices.

• Copies, edits and proofreads all web content.

• Provides content for social media engagement.

• Travels frequently (up to 40% of time) within the National Capital Region (NCR) and throughout U.S. for demonstrations and speaking engagement events.

• Tracks developing events and engagement opportunities.

  Other Job Requirements

Responsibilities

Bachelor's degree in English, Journalism, Technical Writing or equivalent experience.Proven ability to engage and work effectively with senior executives and managers.At least 3 years of experience developing content and production for high-traffic websites.Demonstrated knowledge of best practices in website design and content management.Skills in writing/editing for the web; experience in graphic design and site management.Proven skills in creating and managing collaborative environments.Exceptional communication and organizational skills.Basic graphics skills.

General Job Information

Title

Website Content Coordinator, WCP

Grade

22

Work Experience - Required

Web Design and Development

Work Experience - Preferred

Education - Required

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

Education - Preferred

License and Certifications - Required

License and Certifications - Preferred

Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.

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 providing assistance with the resolution of authorization and/or claim issues in various work queues resulting from and calls taken from facilities and providers. Acts as liaison between providers, internal departments and specific accounts, clients, and claims department.

• Resolves cases in queue due to member eligibility issues, referring provider verification or request, imaging provider verification, redirection, and retro reviews.

• Assists with authorization problem resolution through research and facilitating the resolution of the problem in a timely fashion.

• Process, forward, trend, and maintain records of authorization issues.

• Acts as a troubleshooter to resolve problems among internal departments.

• Handles special requests from Customers requiring manual workarounds or specials projects.

• Investigates written/verbal complaints involving authorizations, and resolves complex issues with Customers and Providers.

• Assists specific accounts who have special processes.

• Observes and tracks authorization problem trends and works with internal department for resolution.

• Assists with User Acceptance Testing (UAT).

• Provides phone back-up coverage for other teams as needed.

  Other Job Requirements

Responsibilities

Ability to review and interpret multiple contract/account information to successfully resolve issues regarding benefit plan administration; experience with account benefit structures.Demonstrated ability for problem solving, meeting deadlines, initiative and follow-through.Excellent written and verbal communication skills.Knowledge of pharmacy benefits management.Understanding of customer service performance metrics (ASA, abandonment rate, talk time).

General Job Information

Title

Customer Resolution Associate

Grade

18

Work Experience - Required

Claims, Customer Service

Work Experience - Preferred

Education - Required

GED, High School

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

Caregiver Peer Support Coordinators (PSCs) will support military caregivers through coordinating convening of the support forums on installations in their respective regions and making known to caregivers the availability of other caregiver-related programs provided by our government clients and non-governmental support agencies.

• Supports military caregivers through coordinating convening of the support forums on installations in their respective regions and making known to caregivers the availability of other caregiver-related programs provided by our government clients and non-governmental support agencies.

  Other Job Requirements

Responsibilities

- Minimum of 3 years' experience associated as being a Caregiver, Social Worker, Counselor, or having worked in the Social Science field or in a medical facility with patients.- Veteran, military spouse or experience working with military organizations.- Excellent interpersonal skills; ability to work effectively across multiple agencies to accomplish project goals.- Strong analytical and communication skills.- Ability to effectively interface and communicate with civilian and military personnel at all levels.- Must be in possession or successfully able to acquire a Secret Clearance.- MS Office proficiency.- Bachelor's Degree or higher.

General Job Information

Title

Peer Support Coordinator, WCP

Grade

21

Work Experience - Required

Military

Work Experience - Preferred

Education - Required

Bachelors

Education - Preferred

License and Certifications - Required

License and Certifications - Preferred

Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.

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

Function as the Regional Coordinator (RC) to facilitate the regular placement of Wounded, Ill, or Injured (WII) Service members (SMs) into internships with participating federal agencies and provide WII SMs educational options and employment opportunities at the location and in areas of interest.

• Aligns with OSD (P&R) in implementing regional and local practices. Adhere to program management protocols received from HQ Program Manager.

• Maintains program operations regionally and locally.

• Maintains and supports strategic partnerships at the regional and local levels.

• Finds and develops internship and employment opportunities, including increased access to career placement assistance.

• Identifies career opportunities with employing organizations to determine qualifications and requirements.

• Finds and develops opportunities for internships, education and training, including assistance in identifying and completing academic or vocational education.

• Conducts outreach to regional and local Veterans Affairs, Federal Government, the private sector and educational institutions, ensuring a foundation for seamless WII SM transition.

• Initiates, develops, and sustains relationships demonstrating community involvement.

• Supports Military Services in the Region in their efforts to assist their WII SMs.

• Develops and sustains relationships demonstrating community engagement.

• Works with WII SMs to identify needs, support requirements, career interests, and education/training requirements.

• Collaborates with the employing institution to facilitate communications and candidate screening for WII SMs.

• Develops individualized development plans for WII SMs and identify training and certification opportunities to fill gaps in skills.

• Assists the Military Services to ensure the WII SM has an advocate and mentor through the end-to-end employment process.

• Captures and submits performance standards and metrics, to include reporting templates and processes; respond to contract performance work statement requirements.

  Other Job Requirements

Responsibilities

Military experience as a Senior NCO or Company Grade Officer or above with technical assignments that are related to counseling, case management, claims, benefits processing, supervision/management, or spouse of the preceding.Excellent presentation skills.Ability to communicate ideas and processes thoroughly and clearly to people at various levels of education and computer competency.Excellent organizational and time management skills.Proficiency with Microsoft Office suite, including Word, Excel, and PowerPoint.Ability to work independently.Superb communication/collaboration skills.Ability to act professionally, confidently, and positively communicate with employees and managers at all levels.Ability to foster an atmosphere of teamwork with others.Ability to present ideas, concepts, issues, concerns, and questions in a well thought out, positive, and professional manner to employees.Excellent presentation skills.Active listening and coaching skills.Operates with minimal supervision.Must be available to travel as required.The ability to work at an accelerated pace.

General Job Information

Title

Regional Coordinator OWF/E2l, WCP

Grade

23

Work Experience - Required

Military

Work Experience - Preferred

Education - Required

High School

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

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

This position is in support of Birmingham Army National Guard . Candidates must be local to the base or be willing to relocate to become local. Candidates must be licensed at the independent level in the state of Alabama as a Social Worker (LICSW), Therapist (LMFT), or Mental Health Counselor (LPC).

Provides the full breadth of MFLC consultation and counseling services to the command structure and military service members and their families as an embedded counselor assigned to a dedicated military unit. Responsible for providing MFLC services including non-medical, short term, walk around counseling, training/health and wellness presentations, and consultation to the brigade/regiments command regarding behavioral health issues with a unique understanding of the particular military unit, cultural and mission.

• Provides non-medical, short-term, solution focused, walk-around counseling directly to service and family members of a dedicated military unit (brigade, wing or regiment) as an embedded counselor. Services include assessment, brief counseling and consultation, action planning, referral to resources (assuring linkage as appropriate), and follow-up as indicated. Delivers training and health and wellness presentations and activities as requested/ directed.

• Enters counselor activity data on a daily basis through smart phone or web application to assure that reporting is accurate from assigned installation, while maintaining client / service member confidentiality.

• Cultivates and maintains direct relationships with commanders and personnel within the assigned military unit, utilizing relationship management skills and recognizing the unique structure and mission of the assigned military unit. Responsible for development of an effective and professional working relationship with the installation POC (Point of Contact), command, and the command POC.

• Creates a presence within the brigade/regiment in which the service and family members feel comfortable approaching the counselor, recognizing the program to be confidential. Establish and maintain working relationships with community resources and provide appropriate linkages for service members and their families. Partners with POC to provide MFLC services in a manner that addresses the needs of the brigade/regiment.

• Provides MFLC response to critical incidents, surge, and special requests as directed by the POC and approved by the Office of Secretary of Defense (OSD) program manager. Counselor will flex schedule to respond to urgent requests as needed.

• Manages duty to warn and restricted reporting situations according to Department of Defense (DoD) protocol and staffs the cases with Regional Supervisor/Regional Director.

• Communicates with Regional Supervisors and participates in regular individual and group supervision, sharing information regarding trends and issues on the installations to which the counselor is assigned.

• Participates in regular in-services/training, Quality Improvement committees or other contract activities as assigned/appropriate.

  Other Job Requirements

Responsibilities

Master's Degree from an accredited Graduate Program in a Mental Health related field.Valid unrestricted counseling license from a State, District of Columbia, US Territory or Commonwealth that grants authority to provide counseling services as an independent practitioner.For assignments in the 50 states, counselors shall be licensed or certified in the state in which the client is receiving services.A minimum two years of post licensure counseling experience.Requires ability to engage and communicate with military members or children as assigned, in order to accomplish job functions, and to respond quickly to emergent situations in any physical location on a military installation and/or within a school setting, which includes the need to traverse short and/or long distances within the base to both indoor and outdoor locations, to maneuver through rugged, outdoor or uneven locations (e.g., steep inclines, stairs, grass), and work in outdoor weather and other military base conditions. May require travel to locations outside of a military base in a variety of physical environments. Due to the nature of working on military installations or related worksites, counselors may need to comply with various site specific requirements to work at designated locations. For example, for some assignments, counselors will need to have certain immunizations or vaccinations and provide record of receipt.Ability to prove US Citizenship and must speak fluent English.Understanding, sensitivity and empathy for service members and their families. Ability to develop trusting, helping relationships. Ability to work effectively with individuals and families from diverse racial, ethnic, and socioeconomic backgrounds.Pass a National Agency Check and Inquiries (NACI) Clearance and an Installation Records Check (IRC), Criminal History Background Check and FBI Fingerprints Check.Some units require a secret level clearance in addition to the previously stated requirements.Vehicle Operator's License Requirement: Unless specifically waived by the FEDSIM COR, all contractor personnel providing counseling support at Government locations shall possess a valid U.S. state vehicle operator's license. As a condition for employment under this contract, contractor personnel may be required to pass all tests for and obtain a U.S. military vehicle operator's permit for commercial sedans and similar, for use at Temporary Duty (TDY) locations, if required.

General Job Information

Title

Military and Family Life Counselor - Embedded

Grade

MFLC Tier 3

Work Experience - Required

Clinical

Work Experience - Preferred

Education - Required

Masters - Behavioral Health, Masters - Social Work

Education - Preferred

License and Certifications - Required

Current licensure required for this position that meets State, Commonwealth or customer-specific requirements - Care Mgmt, DL - Driver License, Valid In State - Other, Must be an independently licensed behavioral health clinician - Care Mgmt

License and Certifications - Preferred

Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.

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

In this position, you would have specific responsibilities to Bucks County and would require travel within Bucks County when appropriate.

Under general supervision, and in collaboration with other members of the clinical team, authorizes and reviews utilization of mental health and substance abuse services provided in inpatient and/or outpatient care settings. Collects and analyzes utilization data. Assists with discharge planning and care coordination. Provides member assistance with mental health and substance abuse issues, and participates in special quality improvement projects.

• Monitors inpatient and/or outpatient level of care services related to mental health and substance abuse treatment to ensure medical necessity and effectiveness.

• Provides telephone triage, crisis intervention and emergency authorizations as assigned.

• Performs concurrent reviews for inpatient and/or outpatient care and other levels of care as allowed by scope of practice and experience.

• In conjunction with providers and facilities, develops discharge plans and oversee their implementation.

• Performs quality clinical reviews while educating and making appropriate interventions to advance the care of the member in treatment.

• Provides information to members and providers regarding mental health and substance abuse benefits, community treatment resources, mental health managed care programs, and company policies and procedures, and criteria.

• Interacts with Physician Advisors to discuss clinical and authorization questions and concerns regarding specific cases.

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

• Maintains an active work load in accordance with National Care Manager performance standards.

• Works with community agencies as appropriate. Proposes alternative plans of treatment when requests for services do not meet medical necessity criteria.

• Participates in network development including identification and recruitment of quality providers as needed.

• Advocates for the patient to ensure treatment needs are met. Interacts with providers in a professional, respectful manner that facilitates the treatment process.

  Other Job Requirements

Responsibilities

Licensure is required for this position, specifically a current license that meets State, Commonwealth or customer-specific requirements. One or more of the following licensure is required for this role with necessary degrees: CEAP, LMSW, LCSW, LSW, LPC or RN.Minimum 2 years experience post degree in healthcare, behavioral health, psychiatric and/or substance abuse health care setting.Strong organization, time management and communication skills.Knowledge of utilization management procedures, mental health and substance abuse community resources and providers.Knowledge and experience in inpatient and/or outpatient setting.Knowledge of DSM V or most current diagnostic edition.Ability to analyze specific utilization problems, plan and implement solutions that directly influence quality of care.

General Job Information

Title

Care Manager

Grade

23

Work Experience - Required

Clinical

Work Experience - Preferred

Education - Required

Associates - Nursing, Bachelors - Social Work, Masters - Social Work

Education - Preferred

License and Certifications - Required

CEAP - Certified Employee Assistance Professional - Care Mgmt, LCSW - Licensed Clinical Social Worker - Care Mgmt, LMFT - Licensed Marital and Family Therapist - Care Mgmt, LMSW - Licensed Master Social Worker - Care Mgmt, LPC - Licensed Professional Counselor - Care Mgmt, LSW - Licensed Social Worker - Care Mgmt, RN - Registered Nurse, State and/or Compact State Licensure - Care Mgmt

License and Certifications - Preferred

Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.

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 ensuring consistent, clear, timely and accurate communications and documentation for operations and other audiences through a variety of communication channels, including email, newsletters, and through the intranet portal. Is also responsible for developing and maintaining resources on intranet portal.

• Writing, reviewing, proofreading and editing all types of communications and documentation to ensure consistency, clarity, accuracy and timeliness. Includes facilitating review process when necessary.

• Interviewing, information gathering, writing and timely distribution of documentation and communication materials.

• Attending appropriate meetings to ensure connection to all operations and health plan information that may impact existing documentation. Includes filtering through meeting content to identify areas of impact and creating strategies to proactively communicate changes to the organization.

• Ongoing maintenance of information posted on intranet portal.

• Continuous improvement of intranet portal.

  Other Job Requirements

Responsibilities

5+ years of experience in public relations or marketing communications.Advanced knowledge of Microsoft Office Suite, SharePoint, and HTML.

General Job Information

Title

Senior Documentation Specialist MediCal

Grade

24

Work Experience - Required

Communications, Public Relations or Related Field, Marketing

Work Experience - Preferred

Education - Required

Bachelors - Marketing

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

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 Sunday to Wednesday 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 Sunday to Wednesday 10:30am to 9:00pm

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 11:30am to 8:00pm 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 11:30am to 8:00pm 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 four 10 hour workdays Sunday to Wednesday 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 Sunday to Wednesday 11:30am to 10:00pm

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 Sunday to Thursday 11:00am to 7:30pm 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 Sunday to Thursday 11:00am to 7:30pm eastern standard time

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 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 four 10 hour workdays Monday, Tuesday, Friday and Saturday 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 workdays Mon, Tues, Fri and Sat 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