Jobs with Chcs Services Inc

Performs Clerical Support to Provider Relations including contract filing, responding to network inquiries, communicating policy information, recording provider complaints, and insuring accuracy of da

The Manager for Monitoring Oversight is responsible for identifying procedures, incidents and patterns of non-compliance within the operational departments of UAM's Medicare Part C and Part D plans, a

To provide executive administrative support to the Executive and selected members of the Executive Team; enable Executive to be as productive and efficient as possible; and represent the organization

Summary: The major responsibility and purpose of this position is to become a subject matter expert on member correspondence materials with a direct level of specialization focused on the ACEP proces

Summary: Lead and manage process improvement projects utilizing Lean Six Sigma methodology within the Corporate Operations group. The Black Belt will work with the Vice President of Corporate Perfor

Summary: Provide education, training, guidance, claims resolution and other duties as assigned for providers in the assigned health plan. Responsibilities: Develop strong interpersonal rel

Summary: The Reconciliation analyst is responsible for identifying, researching and resolving membership discrepancies and associated rejected prescription drug events (PDEs) between the Health Plan

Position Summary: The Special Investigations Unit (SIU) Medicare Parts C and D Intake Coordinator is responsible for assisting/conducting the initial screening of Medicare Parts C and D FWA compla

The Case Management Assistant/SSC assists the clinical Case Manager in both Utilization and Case Management for the integration and coordination of a members care. Responsibilities:

Position Summary: The SIU RN functions as part of the SIU, which is the designated unit responsible for the detection, prevention, investigation, education, correction, and resolution of Medicare

The SIU Investigator functions as part of the SIU, which is the designated unit responsible for the detection, prevention, investigation, education, correction and resolution of FWA. This position is

The SIU Medicare Parts C and D Investigator functions as part of the SIU, which is the designated unit responsible for the detection, prevention, investigation, education, correction, and resolution o

Summary: This position provides daily operational supervision and direction to designated Health Services Department's team members in order to facilitate smooth running of all aspects of the departm

Summary: Develops, organizes, directs and maintains all Case Management, Quality Assurance and Utilization Management functions of the CHS Health Services Department. This position will lead and gui

Position Summary: The Threat Assessment Specialist functions as part of the SIU, which is the designated unit responsible for the detection, prevention, investigation, education, correction

This position is responsible for reviewing suspect claims prior to payment that have been identified as suspicious and/or potentially fraudulent. Utilizing a combination of Company designated tools a

Summary: The Clinical Trainer will facilitate and continually collaborate in the development and improvement in the ACO Medical Management training program. The Clinical Trainer will utilize a variet

Summary: Responsible for providing leadership and continuous improvement to data analytics and reporting processes, required to support the business decision of the Company. This requires the knowled

Summary: Provide education, training, guidance, claims resolution and other duties as assigned for providers in the assigned health plan. Responsibilities: Develop strong interpersonal rel

Summary: Provide education, training, guidance, claims resolution and other duties as assigned for providers in the assigned health plan. Responsibilities: Develop strong interpersonal rel

Summary: Responsible for the coordination and completion of projects related to Physician Practice Management systems, Electronic Medical Records (EMR) and Health Information Exchange (HIE). Sets dea

Job Summary : The ability to define, design and implement databases and reporting of business data from several source systems. The analyst will work closely with both internal and external user

Coordinate all activities involved in the implementation and start-up of an Accountable Care Organization (ACO) with the CHS operations. Partner with the local market staff and leadership to ensure c

To maximize the components of the out-patient settings by utilizing care coordination tools, criteria and protocols to: provide members with chronic and acute conditions the support, educatio

To maximize the components of the in-patient and out-patient settings by utilizing care coordination tools, criteria and protocols to: provide members with chronic and acute conditions the suppo