Care Manager, UM (NYCE) - REMOTE
New York, New York
Summary of Position Support the department's quality of care and cost containment. Provide utilization management as needed to ensure coordination of health care delivery. Conduct medical appropriateness evaluations of acute care hospital a...
5h
| Job Type | Full Time |
Customer Service Representative
Farmington, Connecticut
*** Must be able to commute to work location at 195 Scott Swamp Road, Farmington, CT 06302*** We are seeking dynamic Call Center Professionals to join our Call Center in Farmington, CT starting 2026! Our Call Center professionals provide te...
5h
| Job Type | Full Time |
Quality Outreach Specialist - Remote
New York, New York
Summary of Job Perform provider and member outreach to reconcile member records and validate data entry to support continuous quality improvement in Healthcare Effectiveness Data and Information Set (HEDIS) rates and STAR measures for the e...
5h
| Job Type | Full Time |
New York, New York
Summary of Job Load all Professional, Facility, and Ancillary contracts across all EmblemHealth lines of business in a timely and accurate manner. Provide subject matter expertise in all areas of contract configuration, fee schedules/groupe...
5h
| Job Type | Full Time |
Care Specialist (NYCE) - Remote
New York, New York
Summary of Job Responsible for the execution of the non-clinical aspects of the Care Management process. Ensure information is appropriately entered in the system to effectively execute member care plans, originate authorizations, request c...
5h
| Job Type | Full Time |
Supervisor, Grievance & Appeals (Remote)
New York, New York
Summary of Position Responsible for overseeing the day-to-day operations of the Grievance and Appeal Specialists, ensuring adherence to department performance standards and operational efficiency. Continuously improve the effectiveness and ...
5h
| Job Type | Full Time |
Clinical Quality Auditor - Hybrid
New York, New York
Summary of Job As part of the overall clinical audit process, assess and audit medical record charts to ensure compliance with internal (EmblemHealth) and external regulatory and accreditation requirements. Compare collected data against He...
5h
| Job Type | Full Time |
Calhoun, Georgia
Mission Statement As a Mannington Associate I am expected to conduct myself in a manner which supports the company's values and philosophy, while performing in the best interest of my fellow associates. I am expected to contribute to our mi...
5h
| Job Type | Full Time |
Calhoun, Georgia
2nd shift 3:00 PM - 11:00 PM Monday - Fridays Job Title : Creeler Department : Tufting Department Report To: Shift Supervisor The following is a list of job qualifications and requirements for the job. * Must be able to bend and lift an ave...
5h
| Job Type | Full Time |
Madison, Georgia
Mission Statement As a Mannington Associate I am expected to conduct myself in a manner which supports the company's values and philosophy, while performing in the best interest of my fellow associates. I am expected to contribute to our mi...
5h
| Job Type | Full Time |