Magellan Health

  • Dallas, TX, USA
Magellan Health Remote * (Maryland Heights, MO, USA)
Sep 18, 2021
This is a remote position, allowing you to work from home from anywhere inside the US. This Project Coordinator / Iteration Manager Associate position is an entry level technical project management position and assumes smaller scale projects during a training period or in an assistant capacity to more senior staff until experience is gained (both in terms of understanding Magellan specific business acumen and project management methodology). This role assists in developing and maintaining project charter, detailing project plans, weekly status updates and providing problem resolution. Assists with managing schedules and assignments of project members within a matrix structure. Helps ensure that all project activities are coordinated and supportive of the project scope, time and budget. Must be familiar with the role and function of each team member in order to effectively coordinate the activities of the team. Communicates with Information Technology Director, functional area...
Magellan Health Remote * (Glen Allen, VA, USA)
Sep 18, 2021
Looking for a Lead Software Engineer that can design, develop, and support enterprise level web applications written in technologies like React.js, Vue.js, Angular, Java Spring-Boot services, Spring JDBC, etc. This is a fully remote position, allowing you to work from home from anywhere in the US. Additional Details: - Experience with one or more Javascript front end frameworks (React/Angular/Vue/etc), Spring, Spring Boot, Spring JDBC. - Experience with writing/maintaining stored procedures (preferably MS SQL Server/Transact-SQL) - Experience developing and supporting complex, high availability enterprise web applications - Experience working with Amazon Web Services (AWS) - Experience with one or more continuous integration/continuous delivery tools - Experience with TDD/BDD and one or more unit test frameworks - Experience with report generation tools a plus This position services as an expert technical and industry resource to management, clients and development staff in new...
Magellan Health Remote * (Boston, MA, USA)
Sep 18, 2021
Design, document, develop and roll out financial, clinical and utilization analyses using a variety of computing tools (e.g., SQL, Excel). Perform ad hoc analyses that will vary in duration and complexity - it will be expected that the candidate can balance multiple priorities while maintaining a high level of quality. This position has the responsibility to participate and/or lead in defining the issues to be studied as well as the methodology to be used in addressing these issues. Performs exploratory data analysis and data mining of healthcare claims and authorizations data. Designs, documents, develops and rolls out financial, clinical and utilization analyses using a variety of computing tools (e.g. SQL, Excel). Performs ad hoc analyses that will vary in duration and complexity. Participated in defining issues to be studied as well as the methodology to be used in addressing these issues. Provides status reports that give a detailed description of the current project's...
Magellan Health Remote * (Carmichael, CA, USA)
Sep 18, 2021
This Sr. Director position will have a specific focus on new Client onboarding for Magellan's Specialty division. Needs a depth of understanding of Radiology Benefits Management, process and workflow development, SQL server concepts, and experience working with external customers, internal business stakeholders, and management of staff who will be configuring the systems for new client implementations. This is a fully remote position, allowing you to work from the comfort of your own home. This position is the Analysis, Process, Design and Quality leader for a business unit or an operational area within the company. This role is a unique combination of highly evolved analytical skills and ability to envision, shape, drive a strategy and be creative in order to realize ambitious goals on behalf of the business. A trusted advisor to the business and technical teams who is able to communicate a clear point of view in strategic discussions with executive leadership. Remains poised,...
Magellan Health Remote * (United States)
Sep 18, 2021
Manages and coordinates the company's financial function across sub-functions such as accounting, cost management, budgeting, finance, audit, credit, collections, and tax to meet company's business requirements. Works within corporate strategies and policy frameworks, designs, proposes and implements financial strategies, guidelines and procedures within broad principles and policies set by the organization to meet finance requirements supporting short and long-term business needs. Oversees maintenance of the organization's general ledger and related accounting practices. Oversees all company-wide budgeting, financial planning, control, and reporting policies and practices. Provides economic analyses, studies, and counsel on all matters of potentially significant financial impact to the company, including economic/competitive trends, pricing, cash flow, product line evaluation, and capital additions. Analyzes and reviews monthly results for risk against annual plan and forecast...
Magellan Health Remote * (Maryland Heights, MO, USA)
Sep 18, 2021
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...
Magellan Health Remote * (United States)
Sep 18, 2021
The Pharmacy Benefit Management Pricer/Underwriter is responsible for the development of financial and programmatic cost models. This position will work with various departments within the company as well with employees within the finance department. Assumes a lead role in overseeing all financial aspects of the underwriting process. Applies underwriting policies and procedures to new and existing business Achieve overall corporate financial goals by applying appropriate pricing methodologies. Analyzes claims detail data from multiple in-house claims processing systems, as well as analyzing external claims data in various formats. Meets deadlines and assists with the fulfillment of financial requirements for RFPs which entails review, analysis, development of underwriting models and pricing, completion of all required RFP underwriting and pricing documentation, periodic recalibration and updating of underwriting model assumptions and cost drivers and development of pricing...
Magellan Health Remote * (Plano, TX, USA)
Sep 18, 2021
This position works with internal stakeholders to understand information needs and help develop insightful reports and analytical tools for visualizing, analyzing, and providing access to data that helps users make better business decisions. Responsibilities include storytelling with data and serving up data in an easily consumable way that enables business users to better understand their operating environment. This position will be key to expanding reporting content, capabilities, and access across the company. This is a fully remote opportunity. Synthesizes and refines raw quantitative and qualitative data into visually depicting stories that are comprehensible and impactful to the business. Delivers business-critical data, reports and dashboards for internal and external stakeholders using tools like Tableau, Cognos, Excel, PowerPoint etc. Consults with Magellan stakeholders at all levels of the organization to identify business requirements for member and provider data and...
Magellan Health Remote * (Maryland Heights, MO, USA)
Sep 18, 2021
Looking for a Director within InfoSec that has experience managing an Incident Response team using Splunk in a large enterprise environment. This role would also provide leadership and serve as a technical lead on incident events and incidents. Will be responsible for building out and owning the Product Security Incident Response Components, such as vulnerability disclosure. This position will ensure that we have the skills and capabilities required to deliver on our business and technical commitments. Will focus on Continuous improvement within the area and lead IT initiatives and special projects within their portfolio of applications. Will lead efforts to provide cost and effort estimates for significant new demand. Partners with Service Owners to lead the creation of Technology roadmaps to ensure that the Infrastructure is Current, Resilient and Secure. Monitors Technical Debt and ensures that Technology Roadmaps have plans to retire Technical Debt. Manage 24x7x365 days...
Magellan Health Remote * (United States)
Sep 18, 2021
Leads analytics-based product delivery from inception to implementation. Ideal candidate will have a passion for crafting and selling a vision for the MRx Specialty analytics product, collecting requirements from customers, and working with analytics teams to serve both internal and external stakeholders at a best-in-class level. Helps drive the strategy, roadmap, and priorities for the team. Creates a product plan for analytics as a product, including the scope, resource requirements, timelines, prioritization, platforms, etc. to be submitted to and approved by MRx Specialty GM. Evaluates all analytics outputs and resources currently being utilized by MRx Specialty and determines the best corrective action needed for improvement. Collects input and feedback that will then be incorporated into the analytics product. Develops opportunity analyses to enhance the sales process of current and new clinical programs. Partners with and guides the MRx Analytics/Data teams so that they...
Magellan Health Remote * (Plano, TX, USA)
Sep 15, 2021
This position services as an expert technical and industry resource for SDLC Process automation for our current and new information technology systems. This is a fully remote position, allowing you to work out of the comfort of your own home. Responsible for building automation processes on AWS CodeDeploy, Jenkins, Github integration and ability to build end-to-end SDLC automation processes. - Hands on expertise on Agile development methodology. - Assist in writing test cases derived from each sprint requirements. - Expertise on setting up Data-driven methods for driving DevOps automation for iSeries and SnapLogic based integration. - Drive adoption of DevOps, Platform Automation and Test Automation - CI/CD on Cloud Infrastructure (lower and prod environments), with security as a priority Provides consultation on internal and industry IT technical and business domain process capabilities including leadership in the identification and recommendation of new IT opportunities and...
Magellan Health Remote * (Arlington, VA, USA)
Sep 14, 2021
This position is responsible to develop and manage a strategically aligned business development pipeline. Opportunity lead from initial identification through qualification, working in conjunction with capture management to determine next appropriate steps in the management of the opportunity. Responsible for identifying current and future client requirements and market trends, and position Magellan Federal for business growth. Be familiar with and follow proven business development methodologies and collaborate with other organization functional groups to develop qualification artifacts. Provides training and guidance to less experienced business development personnel. Develops and grows relationship with internally with peer and externally with clients and industry partners.Develops and executes a growth strategy based on Magellan Federal strategic goals and capabilities, client needs, market trends, and the competitive environment to meet assigned growth budgets.Collaborates...
Magellan Health Remote * (Arlington, VA, USA)
Sep 14, 2021
Responsible for timely, accurate processing of accounts payable vouchers and employee expense claims for payment. Research and resolve questions and inquiries from Magellan employees, vendors and providers. Assist management with special projects or tasks as assigned.Invoice Processing:Review approved check requests for proper GL coding and approvals. Review invoices for required information and accuracy.Prepare invoices and PO invoices for A4P processing.Scan the prepared invoices into Kofax. Verify all documents were scanned successfully.Validate scanned invoices. Verify that the populated fields match the information on the invoice. Manually enter missing required information or correct populated information.Retrieve invoice output file. Review the vendor and invoice information on the file. Format the file to import into Lawson.Import the invoice file using Lawson AddIns. Verify that the file was imported correctly. Make the necessary corrections to the invoices that were not...
Magellan Health Remote * (Columbia, MD, USA)
Sep 14, 2021
This position has primary responsibility for leading the proposal process, beginning with initial intake activities through the end creating successful proposal submissions. Role is responsible for providing project management planning, execution and reporting to the proposal project team and leadership. This role project manages commercial, government and managed care organization Request for Proposals (RFPs).Establishes and manages proposal timelines. Identifies potential schedule slippages and develops recovery plan. Raises awareness to minimize exposure and risk on project. Creates and executes proposal work plans and revises, as appropriate, to meet changing needs and requirements. Manages the project plan by ensuring obstacles are identified and mitigated and that deliverables are met on time. Liaison with SMES to ensure writers have what is needed to provide a quality product. Reports project status and apprises management of issues requiring resolution in order to maintain...
Magellan Health Remote * (Scottsdale, AZ, USA)
Sep 14, 2021
Independently performs quality functions within the Quality Department of a Care Center or office. Coordinates projects resulting in continuous quality improvement and process improvement. Supports the maintenance of a strong quality program, measured processes and reported outcomes.Coordinates assigned quality and process improvement activities which may include accreditation support, process improvement projects and monitoring of performance guarantees.Conducts quality control reviews and internal audits.Summarizes findings and prepare reports on findings.Assists in the preparation of customer and external audits.Other Job RequirementsResponsibilitiesUp to 2 years of quality improvement and auditing or related in healthcare field.Knowledge of healthcare quality improvement processes and performance measurement.Attention to detail and ability to work efficiently to meet deadlines and timelines.High degree of organization required.Expertise in data management, data analysis,...
Magellan Health Remote * (Phoenix, AZ, USA)
Sep 09, 2021
This position is responsible for providing accurate, efficient and timely contract support and service for the assigned client. Operational management of assigned book of business in order to achieve profitable retention of accounts. Responsible for timely and accurate entry and maintenance of operational records and information in multiple databases. Researches and resolves questions and complaints, and ensures that information in all databases is accurate and properly configured to support operations.Performs daily operation-specific duties that directly relate to the products and/or services assignedSupports in the development and maintenance of a strategic business plan that fully reflects the clients program objectives and how the company provides solutions to align to those objectives and specifically guides our operational, financial, clinical and relationship initiatives. Understands the client's organizational structure and demonstrates the ability to apply this knowledge...