Change Healthcare

  • Pensacola, FL, USA
Nov 30, 2021
Change Healthcare Remote * (Madison, WI, USA)
Overview of Position This position is required to perform case management activities for health plan members. The activities will include assessing needs, developing a patient-centered care plan, monitoring outcomes, and coordinating interdisciplinary approaches and services. These functions may be performed onsite and/or telephonic. This position works closely with the Health Services Manager and the Medical Director to evaluate, monitor and assure coordination of services, health care coaching and navigation as it relates to condition management, quality, continuity and cost effectiveness. This position is responsible for managing utilization, gaps in care, and performing necessary interventions for positive health outcomes. What will be my duties and responsibilities in this job?+ Performs assessment, screening, and evaluation of patients needs.+ Develops patient-centered care plans+ Facilitates coordination of care for members in various levels of care to ensure appropriateness...
Nov 28, 2021
Change Healthcare Remote * (Alpharetta, GA, USA)
Senior Business Systems Analyst Overview of Position The Senior Business Systems Analyst will work as part of the IT staff to assist in developing and implementing solutions that meet operational needs within our organization. The BA is involved in planning, organizing and conducting detailed analytical studies to define the problems, identify deficiencies and improve solutions which impact the enterprises effectiveness, and provide a basis for issue resolution. The BA is responsible for executing the system definition and design processes within the software development life cycle. They collaborate with users to define business requirements for system enhancements and new functionalities to achieve process improvements . What will be my duties and responsibilities in this job? Analysis of business and user needs, documentation of requirements and translation into proper system requirement specifications Development and documentation of basic test cases to support...
Nov 21, 2021
Change Healthcare Remote * (Pensacola, FL, USA)
Overview of Position The position is primarily accountable for performing initial clinical appropriateness review of requests for services that require prior authorization or retrospective review. The review process is performed in accordance with established Client (health plan) protocols/guidelines, benefits, and clinical appropriateness criteria. This position works closely with the Health Services Manager and the Medical Director to evaluate, monitor and assure the appropriateness and medical necessity of selected care for members as it relates to quality, continuity and cost effectiveness. This position works with non-clinical staff as part of the referral and/or authorization process. This position is responsible for managing utilization and, if necessary, discussing utilization of service and standards of patient management. What will be my duties and responsibilities in this job? Performs initial, concurrent, and/or retrospective review of services that require prior...
Nov 11, 2021
Change Healthcare Remote * (Pensacola, FL, USA)
Overview of Position The position is primarily accountable for performing initial clinical appropriateness review of requests for services that require prior authorization or retrospective review. The review process is performed in accordance with established Client (health plan) protocols/guidelines, benefits, and clinical appropriateness criteria. This position works closely with the Health Services Manager and the Medical Director to evaluate, monitor and assure the appropriateness and medical necessity of selected care for members as it relates to quality, continuity and cost effectiveness. This position works with non-clinical staff as part of the referral and/or authorization process. This position is responsible for managing utilization and, if necessary, discussing utilization of service and standards of patient management. What will be my duties and responsibilities in this job? Performs initial, concurrent, and/or retrospective review of services that require prior...