All Jobs at Buckeye Community Health
6 hours ago
Position Purpose: Provide a link between members and available resources to provide the necessary resources in a cost effective manner. Provide home visits to risk members and families for evaluation of needs in an effort to provide direction of care for...
4 days ago
Position Purpose: Serve as a liaison between the plan, claims, providers and various departments to effectively identify and resolve claims issues Audit check run and send claims to the claims department for corrections Identify any system changes and wor...
5 days ago
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. Assess the member's current health stat...
7 days ago
Position Purpose: Responsible for defining and directing a complete Case Management Program in conjunction with corporate goals and objectives Direct the overall operational leadership of case management functions and staff Perform and oversee needs analy...
7 days ago
Position Purpose: Assist in activities related to the medical and psychosocial aspects of utilization and coordinated care. Initiate authorization requests for output or input services in keeping with the prior authorization list. Research claims inquiry...
1 week ago
Position Purpose: Direct the strategic analysis and accuracy of Claims processes and oversee and ensure compliance with state regulations and/or provider contracts Oversee the collection, validation and analysis of data to deliver business solutions ensur...
4 weeks ago
Position Purpose: Perform onsite review of emergent/urgent and continued stay requests for appropriate care and setting, following guidelines and policies, and approve services or forward requests to the appropriate Physician or Medical Director with reco...
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