Company Detail

Job Description

Serves as liaison between departmental team business owners, end users, IT, Claims and Clinical departments. Responds to ad hoc requests for support, reports and analysis. Supports departmental management team by providing trending and performance data. Supports special projects. Maintains and monitors reporting queues and requests (if appropriate), and internal share point sites. May participate in full life cycle development by performing requirements analysis, process development and design, and testing using development methodology. Collaborates with functional teams, as well as with IT business analysts and programmers to develop detailed design specifications according to standards.

• Develops and documents workflow, systems requirements, system impact analysis, systems design, process analysis and testing (including reasonableness checks) using software development methodology to provide efficient, cost-effective solutions as directed. Identifies impact of solutions on existing and future systems. May perform operational activities.

• Creates and maintains standard related reports to support operational and development needs.

• Manages reporting and requests for ad hoc reports to support sales, implementation, new product development, specials.

• Queries data warehouse and internal databases and prepares user friendly reports according to requestors? requirements.

• Creates and maintains internal management tools and databases to support CQI, rates, workflow business rules and system configuration, reimbursement and document management requirements.

• Develops and maintains project plans. Manages small to medium sized projects, system enhancements impacting data management.

• Conducts root cause analyses, gathering data to pinpoint problem areas on which to focus, validating that the analysis is data driven, recommending and implementing solutions and evaluating those results, and implementing controls to monitor consistent use of the solution.

• Participates in design plans for implementation, produces user documentation and training materials. May conduct end user training.

• Provides status reports that give a detailed description of the current project's progress and indicates time devoted to each task of the project; leads status meetings, creating agendas and documenting meeting minutes as needed.

• Identifies reporting needs based on system configuration and workflows and documents reporting requirements and testing of new reports in development prior to implementation to Production.

• Participates in initiatives or projects that support process improvements, leveraging new system capabilities or the integration of data/other applications into existing systems.

• Performs other duties as assigned.

  Other Job Requirements

Responsibilities

Related professional experience in the managed care, healthcare, or insurance industries.Analytical/problem solving skills.Excellent verbal and written communication skills.Strong PC background and efficient in using standard software.Knowledge of system process analysis and/or program management, estimating IT system development, and testing.For positions supporting Medicare, requires experience working in Medicare Operations.

General Job Information

Title

Business Analyst ADAP focused Gov't Implementations

Grade

23

Work Experience - Required

Business Analysis

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 managing the day-to-day functions of the member enrollment department and ensuring timely and accurate processing of enrollment transactions. The position will lead a business team that supports the delivery of enrollment and eligibility requirements for new client implementations and to meet ongoing client needs. This individual will lead the business team on the delivery and execution of critical enhancements supporting enrollment and eligibility. Ensures team manages performance guarantees, operational goals, and turnaround times.

• Assesses current state of eligibility and identify gaps and improvements.

• Supports day to day operations, new implementations, and projects for eligibility operations.

• Reports performance results to team and management.

• Obtains an in-depth working knowledge of the eligibility department's workflow and the impact to other departments.

• Adheres to budget allocations.

• Manages team performance and provides feedback to individuals.

• Recognizes and rewards effectively; maintains a positive work environment.

• Provides appropriate level of directions and support to team.

• Identifies training needs and executes as needed.

• Manages schedules, time off requests, timesheets, overtime, etc.

• Provides backup to support staff to ensure metrics are always maintained.

• Trains new employees and provides continuous trainings as needed for all employees

• Provides clear and timely communications to team.

• Maintains documentation for all processes and accounts.

• Team audits.

• Special projects as assigned.

  Other Job Requirements

Responsibilities

5+ years of progressive experience with Member Enrollment and Eligibility business operations, preferably at a health plan, managed care organization, third-party administrator, or other healthcare entity.Bachelor's in relevant area or a combination of education and experience.Strong working knowledge of claims, prior authorizations, EDI 834 transactions and member enrollment operations.Strong analytical and organizational skills.Ability to work collaboratively across partner/organizations.Models leadership and takes initiative.Ability to easily manage and be flexible to fluctuations in demand of work and growth; effectively manage by reporting and strategizing on resource needs.Exceptional problem solver with the ability to handle difficult situations; proven ability to remain calm in the face of a challenge and comprehension of when and how to escalate an issue.Exceptional dynamic listening, communication, and presentation skills.

General Job Information

Title

Manager, Enrollment Services

Grade

25

Work Experience - Required

Management/Leadership, Operations

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

Facilitates the company's efforts in the development of medical pharmacy solutions programs. Supports drug utilization review (DUR) efforts by reviewing physician prescribing patterns, consulting with physicians regarding these patterns using evidence-based best practices, working closely with internal staff in the refinement of the company's medical pharmacy management solutions programs, providing consultation on pharmacy issues to clinical operations representatives and facilitating the successful implementation of these programs for customer organizations. Primary activities center on discussions with practicing physicians (and other prescribers) to consult on prescribing of specialty medications. Coordinates with operations, clinical, medical, reporting and other internal departments as needed.

• Pharmacy Data Review: Regularly reviews and monitors prescription claims data and prescribing practices identified as outliers by internal and/or external analysis of pharmacy claims data.

• Telephonic Consultations/Interventions: Contacts physicians and prescribers identified as needing consultation to provide coaching on prescribing practices that have been identified as outliers. Reviews prior authorizations and determine opportunities for interventions.

• Intervention Tracking and Documentation: Tracks contact attempts and contacts per operations procedures. Documents content of and results of consultations as defined in operations procedures; maintains records as required.

• Intervention Refinements: Collaborates on the refinement of consultation scripting; solicits and utilizes input from those contacted toward scripting improvements.

• Operations: Contributes to the success of the operations of the pharmacy program by assisting with the implementation and management of both written and verbal communications to physicians and prescribers and maintenance of the edits and data elements that support the edits. Is available for consultation on pharmacy-related questions and issues for others within the organization (e.g. health coaches, care managers, etc.). Updates and maintains program engine, coding, consultation sheets and outreach program as needed.

• Quality Improvement: Contributes to program improvements by using continuous quality improvement processes, by being proactive in identifying improvement opportunities and by contributing on-going consultation and collaboration with product leaders.

• Medical/Clinical: Upholds clinical integrity of pharmaceutical solutions by staying up-to-date on medication information, contributing to the identification of pharmacy program best practices, collaborating with Medical Directors, Medical Dept, and Clinical Dept and provides pharmacy expertise within the organization.

• Managerial Support : Supports system User Acceptance Testing (UAT), performs monthly call audits to measure and report quality, researches and resolves escalated issues, and maintains and monitors clinical workloads to ensure performance goals are achieved.

• Coaching/Training: Provides support and coaching to Initial Clinical Review (ICR) Pharmacists and other clinical team members in the course of normal operations. Identifies team member training needs and provides real time coaching/training. Act as a mentor to other ICR Pharmacists and other clinical team members.

• Contributes creative solutions to improve operational efficiency and effectiveness of pharmacy team.

  Other Job Requirements

Responsibilities

7+ years' experience in clinical pharmacy with emphasis in specialty pharmacy, oncology or other clinical pharmacy area. Managed care pharmaceutical service experience plus experience with coaching physicians and prescribers on medication issues, especially on specialty medications.Knowledge of current research related to specialty medications.-Strong research and implementation skills in practical settings.Analytic skills which can translate into practical and pragmatic recommendations.Strong team orientation with respect for all members.Strong verbal and written communications skills.People skills are essential that allow for the successful consultation with physicians, prescribers and pharmacists and for successful collaboration with company employees and external vendors who do not directly report to this job.Must be comfortable with using computers and the internet; basic skills with Microsoft office products and ability to quickly learn proprietary systems.For positions supporting Medicare Part B, 5+ years of PBM experience required, 2+ years of Medicare Part B experience required and 2+ years of audit experience required.

General Job Information

Title

Lead Clinical Pharmacist Reviewer MediCal

Grade

30

Work Experience - Required

Pharmacy

Work Experience - Preferred

Education - Required

Bachelors - Pharmacy

Education - Preferred

PharmD - Pharmacy

License and Certifications - Required

RPH - Registered Pharmacist - Pharmacy

License and Certifications - Preferred

PharmD - Doctor Of Pharmacy, State Licensure - 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

Primary function is to supervise the customer care staff responsible for responding to telephone inquiries from providers and members as they relate to eligibility, benefits, claims, and authorization of services. Supervises the staff in the implementation, servicing, and maintenance of accounts and account related activities.

• Manages the customer care management (CMC) and supports services (if applicable) to ensure compliance with policies, procedures and customer requirements.

• Measures performance and productivity against the standards.

• Ensures the care center is meeting telephone access standards for Magellan.

• Provides routine staff supervision activities regarding staffing, disciplinary actions and performance appraisals.

• Interviews and screens applicants for positions within the department.

• Monitors and evaluates data from the call tracking and call management telephone system for accuracy, completeness, inquiry response time and performance issues.

• Ensures associates are given their QI scores, monthly report cards, and their productivity statistics individually.

• Ensures motivational programs are being utilized.

• Manage the department`s customer/support services quality improvement programs to ensure member and provider satisfaction.

• Identifies training needs for the Customer Service Unit in developing specific training programs for the Service Center.

• Responsible for the training and development of lower level staff and maintaining a teamwork environment.

• Manages the complaint and grievance process.

• Coordinates with sales account management and regional staff to provide smooth implementation of new business within the Care Center and Support Services.

  Other Job Requirements

Responsibilities

Minimum 5 years' experience in a call center environment and 2 years' supervisory experience.Must possess service excellence attitude.Demonstrated track record of managing change with proven results.Ability to identify individual and team developmental needs.Ability to effectively coach and develop team members.

General Job Information

Title

Supervisor Customer Care

Grade

22

Work Experience - Required

Customer Service, Supervisory

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

Facilitates the company's efforts in the development of medical pharmacy solutions programs. Supports drug utilization review (DUR) efforts by reviewing physician prescribing patterns, consulting with physicians regarding these patterns using evidence-based best practices, working closely with internal staff in the refinement of the company's medical pharmacy management solutions programs, providing consultation on pharmacy issues to clinical operations representatives and facilitating the successful implementation of these programs for customer organizations. Primary activities center on discussions with practicing physicians (and other prescribers) to consult on prescribing of specialty medications. Coordinates with operations, clinical, medical, reporting and other internal departments as needed.

• Pharmacy Data Review: Regularly reviews and monitors prescription claims data and prescribing practices identified as outliers by internal and/or external analysis of pharmacy claims data.

• Telephonic Consultations/Interventions: Contacts physicians and prescribers identified as needing consultation to provide coaching on prescribing practices that have been identified as outliers. Reviews prior authorizations and determine opportunities for interventions.

• Intervention Tracking and Documentation: Tracks contact attempts and contacts per operations procedures. Documents content of and results of consultations as defined in operations procedures; maintains records as required.

• Intervention Refinements: Collaborates on the refinement of consultation scripting; solicits and utilizes input from those contacted toward scripting improvements.

• Operations: Contributes to the success of the operations of the pharmacy program by assisting with the implementation and management of both written and verbal communications to physicians and prescribers and maintenance of the edits and data elements that support the edits. Is available for consultation on pharmacy-related questions and issues for others within the organization (e.g. health coaches, care managers, etc.). Updates and maintains program engine, coding, consultation sheets and outreach program as needed.

• Quality Improvement: Contributes to program improvements by using continuous quality improvement processes, by being proactive in identifying improvement opportunities and by contributing on-going consultation and collaboration with product leaders.

• Medical/Clinical: Upholds clinical integrity of pharmaceutical solutions by staying up-to-date on medication information, contributing to the identification of pharmacy program best practices, collaborating with Medical Directors, Medical Dept, and Clinical Dept and provides pharmacy expertise within the organization.

• Managerial Support : Supports system User Acceptance Testing (UAT), performs monthly call audits to measure and report quality, researches and resolves escalated issues, and maintains and monitors clinical workloads to ensure performance goals are achieved.

• Coaching/Training: Provides support and coaching to Initial Clinical Review (ICR) Pharmacists and other clinical team members in the course of normal operations. Identifies team member training needs and provides real time coaching/training. Act as a mentor to other ICR Pharmacists and other clinical team members.

• Contributes creative solutions to improve operational efficiency and effectiveness of pharmacy team.

  Other Job Requirements

Responsibilities

7+ years' experience in clinical pharmacy with emphasis in specialty pharmacy, oncology or other clinical pharmacy area. Managed care pharmaceutical service experience plus experience with coaching physicians and prescribers on medication issues, especially on specialty medications.Knowledge of current research related to specialty medications.-Strong research and implementation skills in practical settings.Analytic skills which can translate into practical and pragmatic recommendations.Strong team orientation with respect for all members.Strong verbal and written communications skills.People skills are essential that allow for the successful consultation with physicians, prescribers and pharmacists and for successful collaboration with company employees and external vendors who do not directly report to this job.Must be comfortable with using computers and the internet; basic skills with Microsoft office products and ability to quickly learn proprietary systems.For positions supporting Medicare Part B, 5+ years of PBM experience required, 2+ years of Medicare Part B experience required and 2+ years of audit experience required.

General Job Information

Title

Lead Clinical Pharmacist Reviewer

Grade

30

Work Experience - Required

Pharmacy

Work Experience - Preferred

Education - Required

Bachelors - Pharmacy

Education - Preferred

PharmD - Pharmacy

License and Certifications - Required

RPH - Registered Pharmacist - Pharmacy

License and Certifications - Preferred

PharmD - Doctor Of Pharmacy, State Licensure - 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 has managerial and clinical oversight of the Clinical Pharmacist and Registered Nurse Review Team, playing a key role in medical and pharmacy management. Leads and grows the clinical performance of a team of Clinical Pharmacist and Nurse Reviewers while supporting and enhancing provider experiences, meeting service level agreements, exceeding client expectations, and achieving revenue goals and operational objectives. Responsible for day-to-day tactical activities, performance trending, performance managing/coaching/developing clinical pharmacists/nurses and time management. Responsible for the delivery of superior customer service by maximizing employee clinical performance and ensuring calls are answered effectively and efficiently by supervising inbound and outbound calls, resolving escalated calls, assisting pharmacists/nurses with clinical and/or client related questions, auditing clinical notations for accuracy, ensuring agents adherence to schedules and ensuring compliance to policies, regulations, 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 Clinical Pharmacist and Registered Nurse Reviewers ensuring clinical criteria is accurately collected, notated, and recommendations appropriately made.

• Provides feedback and improvements in daily workflow with technicians/nurses/pharmacists.

• 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, and ensures other business targets are met and exceeded.

• Reviews new and updated client accounts, medications and policies with pharmacists.

• Ensures compliance with clinical policies and procedures.

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

• Monitors inbound and outbound call traffic and makes adjustments based on call traffic patterns.

• 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.

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

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

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

• Monitors agents for quality and training purposes.

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

• Daily authorization reviews, taking into account health plan requirements, including, but not limited to turn around times, type and number of outreaches made, review times, and regulations.

• Coordinates with Initial Review Pharmacy Technician team as needed.

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

• Other duties as assigned.

  Other Job Requirements

Responsibilities

5+ years of clinical pharmacy experience.Managed care pharmaceutical service experience plus experience with coaching physicians and prescribers on medication issues, especially on specialty medications.Knowledge of current clinical research related to specialty medications.Strong clinical research and implementation skills in practical settings.Analytic skills which can translate into practical and pragmatic recommendations.Strong clinical expertise to aid in enhancing the team's clinical skills and knowledgeStrong team orientation with respect for all members.Strong verbal and written communications skills.People skills are essential that allow for the successful consultation with physicians, prescribers and pharmacists and for successful collaboration with company employees and external vendors who do not directly report to this job.Must be comfortable with using computers and the internetBasic skills with Microsoft office products and ability to quickly learn proprietary systems.

General Job Information

Title

Supervisor, Clinical Pharmacist Reviewer MediCal

Grade

30

Work Experience - Required

Clinical, Pharmacy

Work Experience - Preferred

Speciality Pharmacy

Education - Required

Bachelors - Pharmacy

Education - Preferred

PharmD - Pharmacy

License and Certifications - Required

RPH - Registered Pharmacist - Pharmacy

License and Certifications - Preferred

PharmD - Doctor Of Pharmacy, State Licensure - 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 has managerial and clinical oversight of the Clinical Pharmacist and Registered Nurse Review Team, playing a key role in medical and pharmacy management. Leads and grows the clinical performance of a team of Clinical Pharmacist and Nurse Reviewers while supporting and enhancing provider experiences, meeting service level agreements, exceeding client expectations, and achieving revenue goals and operational objectives. Responsible for day-to-day tactical activities, performance trending, performance managing/coaching/developing clinical pharmacists/nurses and time management. Responsible for the delivery of superior customer service by maximizing employee clinical performance and ensuring calls are answered effectively and efficiently by supervising inbound and outbound calls, resolving escalated calls, assisting pharmacists/nurses with clinical and/or client related questions, auditing clinical notations for accuracy, ensuring agents adherence to schedules and ensuring compliance to policies, regulations, 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 Clinical Pharmacist and Registered Nurse Reviewers ensuring clinical criteria is accurately collected, notated, and recommendations appropriately made.

• Provides feedback and improvements in daily workflow with technicians/nurses/pharmacists.

• 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, and ensures other business targets are met and exceeded.

• Reviews new and updated client accounts, medications and policies with pharmacists.

• Ensures compliance with clinical policies and procedures.

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

• Monitors inbound and outbound call traffic and makes adjustments based on call traffic patterns.

• 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.

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

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

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

• Monitors agents for quality and training purposes.

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

• Daily authorization reviews, taking into account health plan requirements, including, but not limited to turn around times, type and number of outreaches made, review times, and regulations.

• Coordinates with Initial Review Pharmacy Technician team as needed.

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

• Other duties as assigned.

  Other Job Requirements

Responsibilities

5+ years of clinical pharmacy experience.Managed care pharmaceutical service experience plus experience with coaching physicians and prescribers on medication issues, especially on specialty medications.Knowledge of current clinical research related to specialty medications.Strong clinical research and implementation skills in practical settings.Analytic skills which can translate into practical and pragmatic recommendations.Strong clinical expertise to aid in enhancing the team's clinical skills and knowledgeStrong team orientation with respect for all members.Strong verbal and written communications skills.People skills are essential that allow for the successful consultation with physicians, prescribers and pharmacists and for successful collaboration with company employees and external vendors who do not directly report to this job.Must be comfortable with using computers and the internetBasic skills with Microsoft office products and ability to quickly learn proprietary systems.

General Job Information

Title

Supervisor, Clinical Pharmacist Reviewer MediCal

Grade

30

Work Experience - Required

Clinical, Pharmacy

Work Experience - Preferred

Speciality Pharmacy

Education - Required

Bachelors - Pharmacy

Education - Preferred

PharmD - Pharmacy

License and Certifications - Required

RPH - Registered Pharmacist - Pharmacy

License and Certifications - Preferred

PharmD - Doctor Of Pharmacy, State Licensure - 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 professional military personnel support services to the U.S. Navy's Identification Card Administration (ICA) program at Navy installations designated as Defense Enrollment Eligibility Reporting System (DEERS) and Real-time Automated Personnel Identification System (RAPIDS) sites.

• Serves as ID Card/Common Access Card (CAC) customer service specialist trained and certified by the Defense Manpower Data Center (DMDC).

• Delivers ID Card services to all personnel assigned to support customer commands, other military service personnel, retirees and their dependents, and contractors verified through the Trusted Associate Sponsorship System (TASS).

• Performs as a Verifying Official (VO) on DEERS/RAPIDS terminal and ensures inputted data for accuracy and correctness.

• Verifies the identity and eligibility of authorized DoD beneficiaries, issues DoD Identification Cards and performs DEERS updates in accordance with DoD regulations and AFI 36-3026.

• Issues and strictly controls Armed Forces identification and privilege cards for all eligible personnel, (i.e., active duty military, retired military, 100% Disabled American Veteran (DAV) and respective dependents and verified contractors.

• Operates and maintains RAPIDS workstations, processes CACs, assists customers with questions concerning identification card eligibility, application requirements and DEERS, and answers telephone inquiries.

• Accomplishes DEERS enrollment and updates for all eligible beneficiaries, reconciles erroneous DEERS information, performs PIN resets, verifying and updating PKI certificates, and provides other ICA services as necessary.

• May also be certified by DMDC as Site Security Manager (SSM) with responsibility for the safekeeping, storing, and accountability of the CAC and related consumable materials.

• Maintains RAPIDS equipment within the physical parameters and configurations established at the time of installation.

• Performs -User Maintenance on RAPIDS equipment.

  Other Job Requirements

Responsibilities

High School diploma or equivalent.1+ years' experience in a Customer Service environment.HR background in one of the following disciplines: Military Pay, Military Personnel, Travel Claims or Navy Transportation.Substitutions for HR background can be from similar experience gained in either the private sector or other Federal Agency.Proficient in both oral and written communication to communicate effectively and explain complex actions regarding military entitlements, allowances and collections.Working knowledge of Microsoft Office Products, i.e. Word, Excel, Power Point.Working knowledge of standard office equipment such as computers, electric typewriters, copiers, fax machines, scanners and other office automation systems.Must be U.S. citizen and possess favorably adjudicated Tier 3 (NACLC) security investigation.

General Job Information

Title

Part Time ID Card Specialist (Personnel Assistant II), NAVY ICA

Grade

WDNICAPAII

Work Experience - Required

Work Experience - Preferred

Education - Required

High School

Education - Preferred

License and Certifications - Required

License and Certifications - Preferred

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

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

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

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

Warning: Employment Scam

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

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

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

Job Detail

• Company:
  Magellan Health Services

Job Description

This role will ensure network adequacy and compliance by interacting with pharmacy providers regarding credentialing, contract language terms and conditions, claims or compensation issues, and provider education. In this role, the network specialist will optimize interactions with providers, and internal business partners to establish and maintain productive relationships to ensure provider retention, compliance with state and federal regulatory requirements and client needs

• Coordinate, review and finalize the credentialing and re-credentialing process for approximately 68,000 network providers.

• Update and maintain the credentialing database to house provider data accessible for CMS and client audits.

• Solicit, review and finalize network contracting packets to ensure network adequacy, client retention and member access.

• Assist in managing the network platforms/adjudication system including input of applicable information to ensure proper claims processing and payment.

• Act as the first point of contact for the Call Center regarding pharmacy contractual issues and escalations.

• Communicate pertinent information such as notices, provider education and payer sheets to pharmacies to prevent claims processing issues impacting members.

• Ensure proper set up of payment information for 68,000 network providers to include bank account information (EFT) and the set up for delivery of HIPAA compliant electronic remittances ( ERA).

• Research and respond to providers and internal team members for payment or member grievances.

• Provide other assistance as needed to the Provider Relations team and other departments.

  Other Job Requirements

Responsibilities

5+ years of experience in PBM, credentialing, claims, insurance administration or a health care setting.Analysis and problem solving skills required.Ability to interface with multi-disciplinary high level professionals.Ability to identify barriers and elevate issues.Strong interpersonal and communication skills, both written and verbal.Ability to establish strong relationships and influence work performance of others.Intermediate MS Excel and strong skills in other MS Office products.

General Job Information

Title

Sr Network Management Specialist, MRx

Grade

22

Work Experience - Required

Healthcare, PBM (Pharmacy Benefit Management)

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

Provides leadership and subject matter expertise in care coordination, clinical program concepts, methods, and activities for unlicensed teams. Builds successful relationships with behavioral health providers, physical health partners, community services and agencies.

• Manage team members` performance through the review of qualitative and quantitative performance results on a regular and ongoing basis. Provide constructive feedback and set improvement milestones when indicated.

• Regularly assess the clinical performance of staff via documentation audits, live service observations and other performance management tools.

• Set clear performance expectations with team and communicate how performance goals are linked to organizational goals and values.

• Motivate and encourage team members to excel. Create a team environment that contributes to a high degree of employee satisfaction.

• Monitor individual team member reliability patterns and take corrective steps when indicated. Utilize the workforce management system to monitor schedule adherence and other work habits.

• Recruit, interview, and select qualified clinical and nonclinical team members, take corrective action for team members who do not meet expectations.

• Lead the clinical team in monitoring and managing care coordination for those members meeting level II or level III behavioral health needs. Oversee program functions such as timeliness of followup from the Health Reimbursement Agreement (HRA).

• Completion and timeliness of the comprehensive needs assessment and the development and implementation of the treatment plan, including collaboration and sharing information with providers as needed for joint treatment planning and for transitions in care.

• Use of reporting to monitor the TAT and completion of duties to meet the contractual requirements.

• Ensures appropriate clinical supervision and case consultation for clinical staff.

• Assists, on an as needed basis, in response to peak work periods.

• Other duties as assigned.

  Other Job Requirements

Responsibilities

Associates level degree in mental health or related field.5 years post degree experience in a behavioral healthcare setting.Ability to function independently and as a team member, analyze specific utilization problems, plan and implement care coordination solutions while maintaining a good rapport and relationship with mental health and substance abuse providers.Considerable skill in interpreting clinical records and treatment information.Working knowledge Microsoft Office Suite.

General Job Information

Title

Supervisor Clinical Care Services

Grade

23

Work Experience - Required

Clinical, Supervisory

Work Experience - Preferred

Education - Required

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

Education - Preferred

License and Certifications - Required

License and Certifications - Preferred

RN - Registered Nurse, State and/or Compact State Licensure - 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 a front-line service position providing assistance to Magellan's members and providers regarding programs, policies, and procedures. Responsibilities include answering incoming calls related to eligibility, benefits, claims and authorization of services from members or providers. Responsibilities also include the administration of intake documentation into the appropriate systems. Overall expectations is to provide outstanding service to internal and external customers and strive to resolve member and provider needs on the first call. Performance expectations are to meet or exceed operations production and quality standards.

• Actively listens and probes callers in a professionally and timely manner to determine purpose of the calls.

• Researches and articulately communicates information regarding member eligibility, benefits, EAP services, claim status, and authorization inquiries to callers while maintaining confidentiality.

• Resolves customer administrative concerns as the first line of contact - this may include claim resolutions and other expressions of dissatisfaction.

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

• Assists in the mentoring and training of new staff.

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

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

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

• Educates providers on how to submit claims and when/where to submit a treatment plan.

• Identifies and responds to Crisis calls and continues assistance with the Clinician until the call has been resolved.

• Informs providers and members on Magellan's appeal process.

• Leads or participates in activities as requested that help improve Care Center performance, excellence and culture.

• Links or makes routine referrals and triage decisions not requiring clinical judgment.

• Performs necessary follow-up tasks to ensure member or provider needs are completely met.

• Provides information regarding Magellan's in-network and out-of-network reimbursement rates and states multiple networks to providers.

• Refers callers requesting provider information to Provider Services regarding Magellan's professional provider selection criteria and application process.

• Refers patients/EAP clients to the Magellan's Care Management team for a provider, EAP affiliate, or Facility.

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

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

• Thoroughly documents customers' comments/information and forwards required information to the appropriate staff.

  Other Job Requirements

Responsibilities

Must be flexible in scheduling and comfortable with change as customer service is an ever-changing environment.Responsible for meeting call handling requirements and daily telephone standards as set forth by management.Must agree to observing service for the purpose of training and quality control.Must be a proficient typist (avg. 35+ WPM) with strong written and verbal communication skills.Must be able to maneuver through various computer platforms while verifying information on all calls.Must be able to talk and type simultaneously.

General Job Information

Title

Customer Care Associate I

Grade

16

Work Experience - Required

Customer Service

Work Experience - Preferred

Education - Required

GED, High School

Education - Preferred

Associates, Bachelors

License and Certifications - Required

License and Certifications - Preferred

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

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

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

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

Warning: Employment Scam

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

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

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

Job Detail

• Company:
  Magellan Health Services

Job Description

Responsible for packaging and shipping medications according to excursion data. Communication and coordination with all parties necessary to ensure timely shipping and delivery of prescription orders in all designated sites.

• Provides a delivery report to the management and completes designated delivery paperwork by end of business daily.

• Assists in maintaining warehouse and inventory areas in a clean and orderly fashion.

• Maintains the shipping station.

• Assists with maintaining accurate inventory by removing expirations.

• Creates pre-packaged supply items when needed.

• Orders supplies necessary for shipping department.

• Packs medication appropriately and affixes a shipping label after the order has been verified by a pharmacist.

• Verifies all documents and demographics are accurate and correspond to one another.

  Other Job Requirements

Responsibilities

Demonstrates a friendly, professional demeanor plus strong written and verbal communication skills resulting in positive interactions with pharmacy team and patients.Requires effective decision making skills for handling Customer problems.

General Job Information

Title

Shipping Tech

Grade

16

Work Experience - Required

Work Experience - Preferred

Customer Service

Education - Required

GED, High School

Education - Preferred

License and Certifications - Required

License and Certifications - Preferred

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

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

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

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

Warning: Employment Scam

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

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

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

Job Detail

• Company:
  Magellan Health Services

Job Description

Responsible for packaging and shipping medications according to excursion data. Communication and coordination with all parties necessary to ensure timely shipping and delivery of prescription orders in all designated sites.

• Provides a delivery report to the management and completes designated delivery paperwork by end of business daily.

• Assists in maintaining warehouse and inventory areas in a clean and orderly fashion.

• Maintains the shipping station.

• Assists with maintaining accurate inventory by removing expirations.

• Creates pre-packaged supply items when needed.

• Orders supplies necessary for shipping department.

• Packs medication appropriately and affixes a shipping label after the order has been verified by a pharmacist.

• Verifies all documents and demographics are accurate and correspond to one another.

  Other Job Requirements

Responsibilities

Demonstrates a friendly, professional demeanor plus strong written and verbal communication skills resulting in positive interactions with pharmacy team and patients.Requires effective decision making skills for handling Customer problems.

General Job Information

Title

Shipping Tech

Grade

16

Work Experience - Required

Work Experience - Preferred

Customer Service

Education - Required

GED, High School

Education - Preferred

License and Certifications - Required

License and Certifications - Preferred

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

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

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

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

Warning: Employment Scam

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

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

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

Job Detail

• Company:
  Magellan Health Services

Job Description

Serves as liaison between departmental team business owners, end users, IT, Claims and Clinical departments. Responds to ad hoc requests for support, reports and analysis. Supports departmental management team by providing trending and performance data. Supports special projects. Maintains and monitors reporting queues and requests (if appropriate), and internal share point sites. May participate in full life cycle development by performing requirements analysis, process development and design, and testing using development methodology. Collaborates with functional teams, as well as with IT business analysts and programmers to develop detailed design specifications according to standards.

• Develops and documents workflow, systems requirements, system impact analysis, systems design, process analysis and testing (including reasonableness checks) using software development methodology to provide efficient, cost-effective solutions as directed. Identifies impact of solutions on existing and future systems. May perform operational activities.

• Creates and maintains standard related reports to support operational and development needs.

• Manages reporting and requests for ad hoc reports to support sales, implementation, new product development, specials.

• Queries data warehouse and internal databases and prepares user friendly reports according to requestors? requirements.

• Creates and maintains internal management tools and databases to support CQI, rates, workflow business rules and system configuration, reimbursement and document management requirements.

• Develops and maintains project plans. Manages small to medium sized projects, system enhancements impacting data management.

• Conducts root cause analyses, gathering data to pinpoint problem areas on which to focus, validating that the analysis is data driven, recommending and implementing solutions and evaluating those results, and implementing controls to monitor consistent use of the solution.

• Participates in design plans for implementation, produces user documentation and training materials. May conduct end user training.

• Provides status reports that give a detailed description of the current project's progress and indicates time devoted to each task of the project; leads status meetings, creating agendas and documenting meeting minutes as needed.

• Identifies reporting needs based on system configuration and workflows and documents reporting requirements and testing of new reports in development prior to implementation to Production.

• Participates in initiatives or projects that support process improvements, leveraging new system capabilities or the integration of data/other applications into existing systems.

• Performs other duties as assigned.

  Other Job Requirements

Responsibilities

Related professional experience in the managed care, healthcare, or insurance industries.Analytical/problem solving skills.Excellent verbal and written communication skills.Strong PC background and efficient in using standard software.Knowledge of system process analysis and/or program management, estimating IT system development, and testing.For positions supporting Medicare, requires experience working in Medicare Operations.

General Job Information

Title

Business Analyst II

Grade

23

Work Experience - Required

Business Analysis

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

Responsible for packaging and shipping medications according to excursion data. Communication and coordination with all parties necessary to ensure timely shipping and delivery of prescription orders in all designated sites.

• Provides a delivery report to the management and completes designated delivery paperwork by end of business daily.

• Assists in maintaining warehouse and inventory areas in a clean and orderly fashion.

• Maintains the shipping station.

• Assists with maintaining accurate inventory by removing expirations.

• Creates pre-packaged supply items when needed.

• Orders supplies necessary for shipping department.

• Packs medication appropriately and affixes a shipping label after the order has been verified by a pharmacist.

• Verifies all documents and demographics are accurate and correspond to one another.

  Other Job Requirements

Responsibilities

Demonstrates a friendly, professional demeanor plus strong written and verbal communication skills resulting in positive interactions with pharmacy team and patients.Requires effective decision making skills for handling Customer problems.

General Job Information

Title

Shipping Tech

Grade

16

Work Experience - Required

Work Experience - Preferred

Customer Service

Education - Required

GED, High School

Education - Preferred

License and Certifications - Required

License and Certifications - Preferred

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

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

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

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

Warning: Employment Scam

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

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

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

Job Detail

• Company:
  Magellan Health Services

Job Description

Must be a Florida Registered Technician

Performs the basic duties of a pharmacy technician in all designated sites. Including and not limited to, prescription data entry, as well as communicate and coordinate with all parties necessary to insure timely shipping and delivery of prescription orders. Pulls and labels medication for pharmacist verification. Packs medications appropriately and affixes a shipping label after the order has been verified by a pharmacist. Performs all basic duties of a pharmacy technician allowable by legal licensure and registration.

• Under the supervision of a pharmacist, picks and affixes labels to packages of prepackaged and unit dose drugs in accordance with the dispensing order. Prepares and affixes shipping labels to the individual patient shipping containers.

• Answers external phone calls pertinent to department assignment.

• Assembles and packages medications, supplies and equipment in appropriate shipping containers.

• Assists with maintaining accurate inventory through pulling expirations.

• Attends designated department meetings as scheduled.

• Communicates and coordinates internally with customer service, billing, pharmacy, and shipping departments to move patient orders through the system and meet the promised delivery date.

• Communicates by phone and fax as necessary with patient, physician office, and insurance to make sure pharmacy has most updated prescription and prior authorization information on file.

• Creates pre-packages supply items.

• Maintains necessary licensure needed for pharmacy technicians.

• Maintains the pharmacy department according to state and federal regulations.

• Picks supplies and equipment for patient orders as indicated on the delivery ticket.

• Prepares delivery tickets including prescription and supply items as necessary.

• Prints delivery tickets, collates and triages delivery tickets according to excursion data.

• Receives and processes data entry of new and refill prescriptions in the pharmacy computer system.

• Recognizes and identifies various classifications of medications, dosage form and routes of administration.

• Verifies prescription elements are present on all prescriptions.

  Other Job Requirements

Responsibilities

Must have pharmacy intern license as required by applicable state laws OR:Must have an active pharmacy technician licensure or registration in accordance with state requirements.If state does not require an exam for licensure/registration, must possess both active pharmacy technician licensure or registration in accordance with state requirements AND an active national certification (e.g., PTCB or ExCPT).In states that do not require licensure or registration, must have an active national certification (e.g., PTCB or ExCPT).Specialty or retail pharmacy industry experience, previous reimbursement experience, and/or working in a health plan/health care setting.Proficiency in Pharmacy computerized systems and software applications, as well as MS Office Product Suite.Excellent written and verbal communication skills.Ability to identify and trouble-shoot problematic issues.Pharmacy technician experience in prescription entry, picking, labeling and preparing medication orders for pharmacist verification.

General Job Information

Title

On-Site Pharmacy Technician 1

Grade

17

Work Experience - Required

Pharmacy

Work Experience - Preferred

Education - Required

GED, High School

Education - Preferred

License and Certifications - Required

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

License and Certifications - Preferred

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

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

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

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

Warning: Employment Scam

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

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

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

Job Detail

• Company:
  Magellan Health Services

Job Description

Responsible for packaging and shipping medications according to excursion data. Communication and coordination with all parties necessary to ensure timely shipping and delivery of prescription orders in all designated sites.

• Provides a delivery report to the management and completes designated delivery paperwork by end of business daily.

• Assists in maintaining warehouse and inventory areas in a clean and orderly fashion.

• Maintains the shipping station.

• Assists with maintaining accurate inventory by removing expirations.

• Creates pre-packaged supply items when needed.

• Orders supplies necessary for shipping department.

• Packs medication appropriately and affixes a shipping label after the order has been verified by a pharmacist.

• Verifies all documents and demographics are accurate and correspond to one another.

  Other Job Requirements

Responsibilities

Demonstrates a friendly, professional demeanor plus strong written and verbal communication skills resulting in positive interactions with pharmacy team and patients.Requires effective decision making skills for handling Customer problems.

General Job Information

Title

Shipping Tech

Grade

16

Work Experience - Required

Work Experience - Preferred

Customer Service

Education - Required

GED, High School

Education - Preferred

License and Certifications - Required

License and Certifications - Preferred

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

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

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

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

Warning: Employment Scam

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

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

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

Job Detail

• Company:
  Magellan Health Services

Job Description

Must be a Florida Registered Technician

Performs the basic duties of a pharmacy technician in all designated sites. Including and not limited to, prescription data entry, as well as communicate and coordinate with all parties necessary to insure timely shipping and delivery of prescription orders. Pulls and labels medication for pharmacist verification. Packs medications appropriately and affixes a shipping label after the order has been verified by a pharmacist. Performs all basic duties of a pharmacy technician allowable by legal licensure and registration.

• Under the supervision of a pharmacist, picks and affixes labels to packages of prepackaged and unit dose drugs in accordance with the dispensing order. Prepares and affixes shipping labels to the individual patient shipping containers.

• Answers external phone calls pertinent to department assignment.

• Assembles and packages medications, supplies and equipment in appropriate shipping containers.

• Assists with maintaining accurate inventory through pulling expirations.

• Attends designated department meetings as scheduled.

• Communicates and coordinates internally with customer service, billing, pharmacy, and shipping departments to move patient orders through the system and meet the promised delivery date.

• Communicates by phone and fax as necessary with patient, physician office, and insurance to make sure pharmacy has most updated prescription and prior authorization information on file.

• Creates pre-packages supply items.

• Maintains necessary licensure needed for pharmacy technicians.

• Maintains the pharmacy department according to state and federal regulations.

• Picks supplies and equipment for patient orders as indicated on the delivery ticket.

• Prepares delivery tickets including prescription and supply items as necessary.

• Prints delivery tickets, collates and triages delivery tickets according to excursion data.

• Receives and processes data entry of new and refill prescriptions in the pharmacy computer system.

• Recognizes and identifies various classifications of medications, dosage form and routes of administration.

• Verifies prescription elements are present on all prescriptions.

  Other Job Requirements

Responsibilities

Must have pharmacy intern license as required by applicable state laws OR:Must have an active pharmacy technician licensure or registration in accordance with state requirements.If state does not require an exam for licensure/registration, must possess both active pharmacy technician licensure or registration in accordance with state requirements AND an active national certification (e.g., PTCB or ExCPT).In states that do not require licensure or registration, must have an active national certification (e.g., PTCB or ExCPT).Specialty or retail pharmacy industry experience, previous reimbursement experience, and/or working in a health plan/health care setting.Proficiency in Pharmacy computerized systems and software applications, as well as MS Office Product Suite.Excellent written and verbal communication skills.Ability to identify and trouble-shoot problematic issues.Pharmacy technician experience in prescription entry, picking, labeling and preparing medication orders for pharmacist verification.

General Job Information

Title

On-Site Pharmacy Technician 1

Grade

17

Work Experience - Required

Pharmacy

Work Experience - Preferred

Education - Required

GED, High School

Education - Preferred

License and Certifications - Required

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

License and Certifications - Preferred

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

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 hold an independent license such as LPC, LCSW, LMFT, etc. in the state of VA

Primary responsibility of providing 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 assure 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 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 of 5 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 be fluent in 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 socio-economic backgrounds.Pass a National Agency Check and Inquiries (NACI) Clearance and an Installation Records Check (IRC), Criminal History Background Check and FBI Fingerprints Check.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 Therapist - Cyber Defense Operations

Grade

MFLC Tier 4

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

This position may require travel to surrounding offices to cover as needed.

Provides professional military personnel support services to the U.S. Navy's Identification Card Administration (ICA) program at Navy installations designated as Defense Enrollment Eligibility Reporting System (DEERS) and Real-time Automated Personnel Identification System (RAPIDS) sites.

• Serves as ID Card/Common Access Card (CAC) customer service specialist trained and certified by the Defense Manpower Data Center (DMDC).

• Delivers ID Card services to all personnel assigned to support customer commands, other military service personnel, retirees and their dependents, and contractors verified through the Trusted Associate Sponsorship System (TASS).

• Performs as a Verifying Official (VO) on DEERS/RAPIDS terminal and ensures inputted data for accuracy and correctness.

• Verifies the identity and eligibility of authorized DoD beneficiaries, issues DoD Identification Cards and performs DEERS updates in accordance with DoD regulations and AFI 36-3026.

• Issues and strictly controls Armed Forces identification and privilege cards for all eligible personnel, (i.e., active duty military, retired military, 100% Disabled American Veteran (DAV) and respective dependents and verified contractors.

• Operates and maintains RAPIDS workstations, processes CACs, assists customers with questions concerning identification card eligibility, application requirements and DEERS, and answers telephone inquiries.

• Accomplishes DEERS enrollment and updates for all eligible beneficiaries, reconciles erroneous DEERS information, performs PIN resets, verifying and updating PKI certificates, and provides other ICA services as necessary.

• May also be certified by DMDC as Site Security Manager (SSM) with responsibility for the safekeeping, storing, and accountability of the CAC and related consumable materials.

• Maintains RAPIDS equipment within the physical parameters and configurations established at the time of installation.

• Performs -User Maintenance on RAPIDS equipment.

  Other Job Requirements

Responsibilities

High School diploma or equivalent.1+ years' experience in a Customer Service environment.HR background in one of the following disciplines: Military Pay, Military Personnel, Travel Claims or Navy Transportation.Substitutions for HR background can be from similar experience gained in either the private sector or other Federal Agency.Proficient in both oral and written communication to communicate effectively and explain complex actions regarding military entitlements, allowances and collections.Working knowledge of Microsoft Office Products, i.e. Word, Excel, Power Point.Working knowledge of standard office equipment such as computers, electric typewriters, copiers, fax machines, scanners and other office automation systems.Must be U.S. citizen and possess favorably adjudicated Tier 3 (NACLC) security investigation.

General Job Information

Title

Part Time Intermittent ID Card Specialist (Personnel Assistant II), NAVY ICA

Grade

WDNICAPAII

Work Experience - Required

Work Experience - Preferred

Education - Required

High School

Education - Preferred

License and Certifications - Required

License and Certifications - Preferred

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

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

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

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

Warning: Employment Scam

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

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

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

Job Detail

• Company:
  Magellan Health Services

Job Description

Master Resilience Trainer - Performance Experts (MRT-PE) support government client's program at multiple locations. MRT-PEs teach mental skills, resilience and performance enhancement techniques to military Soldiers, Families and DA Civilians. Teaching is conducted in group and individual settings and includes general education in human performance along with personalized training on how to acquire and apply specific mental skills and techniques that cultivate the mental and emotional strength necessary to thrive in an environment of overwhelming demands and persistent conflict. The mental skills and techniques taught by the program include: Building Confidence, Goal Setting, Attention Control, Energy Management, Integrating Imagery and Team Building. Using these principles, MRT-PEs help the clients to become high performing -tactical athletes- and help foster high performing -unit teams- in preparation for, during, and following combat operations. Specifically, MRT-PEs teach performance psychology to further promote excellence and efficiency during physical, technical and tactical training, as well as during the challenges of combat operations. MRT-PEs also provide tailored education to facilitate Wounded Warriors in their transition back to their units or to civilian life. The program teams are comprised of 5-10 MRT-PEs and led by a seasoned Site Manager with prior military experience.

• Attends training exercises and field operations as requested by individual units to serve as a performance enhancement consultant and to coach the clients and leaders on the acquisition of performance psychology techniques and their application to individual military tasks and unit operations.

• Provides tailored educational programs and workshops to help Families and Civilians living and working in demanding environments achieve success and accomplish personal, professional and family goals.

• Recommends improvements to all aspects of the program operations.

• Performs routine program operational duties.

• Conducts assessment, assists in program evaluation and supports research projects being conducted locally.

• Assists or provides program overview briefings to VIPs and high-ranking leaders when required.

• Develops and maintains professional development relating to all aspects of performance enhancement, academic proficiency and military-related knowledge.

  Other Job Requirements

Responsibilities

Master's or Doctoral degree from an accredited college or university in the field of Psychology or Kinesiology with a specialized emphasis in sport and/or performance psychology. Must be able to operate general office equipment including but not limited to: computer, phones and related media and information devices on most or all workdays.Ability to communicate and interact with others, both in person and/or by telephone to conduct business.Experience and ability to work under time pressure.Working rapidly for long periods to meet deadlines.Must be able to travel as needed and adhere to AFSC travel policies and procedures.Must be able to enter private homes that may or may not provide easy access for those with physical disabilities or those recovering from physical rehabilitation or post-recovery mobility.Position requires ability to transport self from office locations to private homes, other offices and facilities where training and other program activities occur.Physical requirements can typically be characterized as active: Lifting, bending, sitting on the floor, climbing may be required in the position. Requires lifting or moving various pieces of equipment, maximum 40 lbs. Position may require work on hands and knees to conduct program activities.Ability to manage multiple concurrent tasks and perform under stress.Requires reading and comprehension proficiency.Requires effective writing and problem solving skills.Ability to maintain confidentiality.Customer contact expertise.Travel requirement: 25%.

General Job Information

Title

Master Resilience Trainer - Performance Expert, ARD-TS

Grade

22

Work Experience - Required

Work Experience - Preferred

Education - Required

Masters - Kinesiology, Masters - Psychology

Education - Preferred

PhD

License and Certifications - Required

License and Certifications - Preferred

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

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

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

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

Warning: Employment Scam

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

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

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

Job Detail

• Company:
  Magellan Health Services

Job Description

Candidates must have one of the following licenses in the state of Pennsylvania: RN, LCSW, LPC, LMFT

Candidates with experience with clients/members with serious and persistent mental illnesses are strongly preferred

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 - Behavioral Health

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

Provides professional military personnel support services to the U.S. Navy's Identification Card Administration (ICA) program at Navy installations designated as Defense Enrollment Eligibility Reporting System (DEERS) and Real-time Automated Personnel Identification System (RAPIDS) sites.

• Serves as ID Card/Common Access Card (CAC) customer service specialist trained and certified by the Defense Manpower Data Center (DMDC).

• Delivers ID Card services to all personnel assigned to support customer commands, other military service personnel, retirees and their dependents, and contractors verified through the Trusted Associate Sponsorship System (TASS).

• Performs as a Verifying Official (VO) on DEERS/RAPIDS terminal and ensures inputted data for accuracy and correctness.

• Verifies the identity and eligibility of authorized DoD beneficiaries, issues DoD Identification Cards and performs DEERS updates in accordance with DoD regulations and AFI 36-3026.

• Issues and strictly controls Armed Forces identification and privilege cards for all eligible personnel, (i.e., active duty military, retired military, 100% Disabled American Veteran (DAV) and respective dependents and verified contractors.

• Operates and maintains RAPIDS workstations, processes CACs, assists customers with questions concerning identification card eligibility, application requirements and DEERS, and answers telephone inquiries.

• Accomplishes DEERS enrollment and updates for all eligible beneficiaries, reconciles erroneous DEERS information, performs PIN resets, verifying and updating PKI certificates, and provides other ICA services as necessary.

• May also be certified by DMDC as Site Security Manager (SSM) with responsibility for the safekeeping, storing, and accountability of the CAC and related consumable materials.

• Maintains RAPIDS equipment within the physical parameters and configurations established at the time of installation.

• Performs -User Maintenance on RAPIDS equipment.

  Other Job Requirements

Responsibilities

High School diploma or equivalent.1+ years' experience in a Customer Service environment.HR background in one of the following disciplines: Military Pay, Military Personnel, Travel Claims or Navy Transportation.Substitutions for HR background can be from similar experience gained in either the private sector or other Federal Agency.Proficient in both oral and written communication to communicate effectively and explain complex actions regarding military entitlements, allowances and collections.Working knowledge of Microsoft Office Products, i.e. Word, Excel, Power Point.Working knowledge of standard office equipment such as computers, electric typewriters, copiers, fax machines, scanners and other office automation systems.Must be U.S. citizen and possess favorably adjudicated Tier 3 (NACLC) security investigation.

General Job Information

Title

Part Time Intermittent ID Card Specialist (Personnel Assistant II), NAVY ICA

Grade

WDNICAPAII

Work Experience - Required

Work Experience - Preferred

Education - Required

High School

Education - Preferred

License and Certifications - Required

License and Certifications - Preferred

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

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

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

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

Warning: Employment Scam

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

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

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

Job Detail

• Company:
  Magellan Health Services

Job Description

Provides support to Claims Operations by investigating and resolving systemic issues relative to claims processing system files and interfaces for membership, authorizations, providers, pricing, reporting and financial. Assist in testing and documenting of account specific benefits to ensure accurate claims adjudication. The position assists in ensuring system performance and resolution of system problems that may impede claims processing.

• Assists in testing of system enhancements and modifications.

• Assists with development of system enhancements and analysis of system performance.

• Performs root cause analysis and resolve system problems identified by claims examiners or other internal staff.

• Assists in testing and documenting of account specific benefits and system enhancements.

• Performs audits of each changed or newly configured plan to ensure that benefits are added accurately and consistently across the various plans.

• Analyzes structure to identify any issues or concerns with the benefit structure provided.

• Interfaces with other departments to obtain information to resolve issues related to system enhancements and plan configuration.

• Maintains working knowledge of multiple testing environments, multiple accounts and multiple job functions.

• Provides backup support to other team/group members in the performance of job duties assigned.

  Other Job Requirements

Responsibilities

5+ years claims processing experience.Knowledge of ICD-9 and CPT coding terminology.Knowledge and understanding of database management and documentation.

General Job Information

Title

Claims System Specialist II

Grade

19

Work Experience - Required

Claims

Work Experience - Preferred

Education - Required

Education - Preferred

Bachelors

License and Certifications - Required

License and Certifications - Preferred

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

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

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

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

Warning: Employment Scam

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

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

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

Job Detail

• Company:
  Magellan Health Services

Job Description

Provides professional military personnel support services to the U.S. Navy's Identification Card Administration (ICA) program at Navy installations designated as Defense Enrollment Eligibility Reporting System (DEERS) and Real-time Automated Personnel Identification System (RAPIDS) sites.

• Serves as ID Card/Common Access Card (CAC) customer service specialist trained and certified by the Defense Manpower Data Center (DMDC).

• Delivers ID Card services to all personnel assigned to support customer commands, other military service personnel, retirees and their dependents, and contractors verified through the Trusted Associate Sponsorship System (TASS).

• Performs as a Verifying Official (VO) on DEERS/RAPIDS terminal and ensures inputted data for accuracy and correctness.

• Verifies the identity and eligibility of authorized DoD beneficiaries, issues DoD Identification Cards and performs DEERS updates in accordance with DoD regulations and AFI 36-3026.

• Issues and strictly controls Armed Forces identification and privilege cards for all eligible personnel, (i.e., active duty military, retired military, 100% Disabled American Veteran (DAV) and respective dependents and verified contractors.

• Operates and maintains RAPIDS workstations, processes CACs, assists customers with questions concerning identification card eligibility, application requirements and DEERS, and answers telephone inquiries.

• Accomplishes DEERS enrollment and updates for all eligible beneficiaries, reconciles erroneous DEERS information, performs PIN resets, verifying and updating PKI certificates, and provides other ICA services as necessary.

• May also be certified by DMDC as Site Security Manager (SSM) with responsibility for the safekeeping, storing, and accountability of the CAC and related consumable materials.

• Maintains RAPIDS equipment within the physical parameters and configurations established at the time of installation.

• Performs -User Maintenance on RAPIDS equipment.

  Other Job Requirements

Responsibilities

High School diploma or equivalent.1+ years' experience in a Customer Service environment.HR background in one of the following disciplines: Military Pay, Military Personnel, Travel Claims or Navy Transportation.Substitutions for HR background can be from similar experience gained in either the private sector or other Federal Agency.Proficient in both oral and written communication to communicate effectively and explain complex actions regarding military entitlements, allowances and collections.Working knowledge of Microsoft Office Products, i.e. Word, Excel, Power Point.Working knowledge of standard office equipment such as computers, electric typewriters, copiers, fax machines, scanners and other office automation systems.Must be U.S. citizen and possess favorably adjudicated Tier 3 (NACLC) security investigation.

General Job Information

Title

Part Time Intermittent ID Card Specialist (Personnel Assistant II), NAVY ICA

Grade

WDNICAPAII

Work Experience - Required

Work Experience - Preferred

Education - Required

High School

Education - Preferred

License and Certifications - Required

License and Certifications - Preferred

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

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

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

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

Warning: Employment Scam

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

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

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

Job Detail

• Company:
  Magellan Health Services