Fond du Lac Jobs
Behavioral Health Quality Management Administrator
Position Purpose: Plans, organizes, monitors, and oversees projects utilizing cross functional teams to deliver defined requirements and meet company strategic objectives. Support the full project life cycle including requirements gathering, creation of p
Data Integrity Specialist
Position Purpose: Act as a liaison between the health plan, external agencies, internal teams to ensure accurate and complete data reporting for provider, credentialing, enrollment, contracting or various related data. Analyze and determine provider code
Supervisor, Office Services (IT)
Position Purpose: Supervise office facilities, administrative support and maintenance of office budget Supervise day to day activities of administrative staff Supervise facility needs such as general building maintenance, key distribution, employee and vi
Lead Intake & Insurance Verification Coordinator
Position Purpose: Obtain and verify complete insurance information, including the prior authorization process, copay assistance and coordination of benefits Assist with managing the work load to ensure that referrals and orders are handled in a timely man
Senior Director, Community Outreach and Employee Involvement
Position Purpose: Develop and oversee Employee Involvement and Community Outreach programs for Centene Promote Centene’s corporate social responsibility brand reputation and continue to further enhance the organization’s reputation within local communitie
Care Manager I (RN) - Yakima
Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care Develop, assess and adjust, as necessary
Manager, Compliance
Position Purpose: Manage the compliance department functions, including but not limited to, periodic monitoring and auditing activities based on established compliance program, policies, and practices to ensure and maintain compliance with federal, state,
Trainer-Auditor (Clinical)
Position Purpose: Responsible for developing and conducting a variety of training programs and auditing tools. Conduct training needs analyses to determine specific training needs for clinical staff Identify, select, or develop appropriate training progra
Manager, Intake & Insurance Verification
Position Purpose: Manage all activities related to the intake, referral management and insurance verification functions, including implementation of initiatives. Develop indicators for monitoring and evaluating quality of work and meeting turnaround time
Manager, Quality Improvement
Position Purpose: Oversee and manage the functions of the quality improvement program. Providing support to staff and communicate with departments and staff to facilitate daily quality improvement (QI) functions. Review and analyze reports, records and di
Quality Improvement Coordinator
Position Purpose: Perform ongoing measurement, analysis, and monitoring of business process and member outcomes data sets. Perform ongoing quantitative and statistical analysis of Cenpatico performance data to include HEDIS measures, service utilization a
Data Analyst III
Position Purpose: Responsible for analytic data needs of the business unit. Handle complex data projects and acts as a lead for other Data Analysts. Provide advanced analytical support for business operations in all or some of the following areas: claims,
Pharmacist
Position Purpose: Coordinate and assist in managing and participating in pharmacy services, including compounding and dispensing of medications, quality assurance and clinical monitoring activities. Participate in decisions regarding the pharmaceutical se
Behavioral Case Manager (Tampa, Jacksonville, Orlando, Sunrise)
Position Purpose: Perform duties related to the day-to-day operations of the High Risk Case Management functions to include working with members identified as high risk to identify needs and goals to achieve empowerment and improved quality of life. Asses
RN Case Manager - (11 am - 8 pm)
Position Purpose: Provide ongoing support and expertise through comprehensive assessment, planning and implementation of case management services for providers and their patients with chronic disease. Perform activities related to the case management of p
Billing & Collection Specialist
Position Purpose: Perform all activities related to collections Verify insurance eligibility for services provided Verify insurance eligibility for all accounts with questionable status or billing addresses Perform price negotiations and discounts related
Utilization Manager (Florida -Sunrise, Tampa, Orlando, Jacksonville)
Position Purpose: Perform duties to authorize and review utilization of mental health and substance abuse services provided in inpatient, outpatient and intermediate care settings, provide and/or review intakes and initial evaluations, brief focused treat
Physical Security Operations Specialist
Position Purpose: Implement changes to Centene’s security platform to mitigate risks Examine and evaluate physical security conditions and risks, make recommendations and implement changes, improvements or corrections Collaborate with facilities to implem
Teppanyaki Chef
Responsible for engaging, entertaining, interacting and providing a unique dining experience to guests. Primarily works in front of restaurant while cooking and preparing hot meals on hibachi tables directly in front of guests. Ensures correct food portio
Utility Technician
K&H Facility Services, a wholly owned subsidiary of Kiemle & Hagood Company, is looking for a Utility Technician. This is an entry-level position supporting facility technicians and building maintenance operations. They may take work direction from variou