of Position We are seeking a talented Grievance & Appeals Specialist who will be responsible for responding to written/verbal grievances, complaints, appeals, and disputes submitted by members and providers in accordance with NCQA, CMS, State, and other regulations. They will process appeals and grievances to facilitate the accurate administration of benefits and clinical

of Position We are seeking a dynamic Grievance and Appeals Dispute Specialist who will be responsible for processing disputes submitted by contracted and non contracted providers. The types of correspondence handled by the individual will include, but is not limited to; correspondence, HQSI/ESMSEF appeals and Cotiviti disputes. This individual will provide technical and ad

Serves in an account management (non sales) role as the primary business to business liaison between ConnectiCare and its provider network and is responsible for all interactions between the organizations. Continuously educates provider community about ConnectiCare and its policies and procedures. Build and develop partnerships with ConnectiCare's Tier I and Tier II provi

Make an Impact! Provide general nursing care to patients as well as care coordination in collaboration with other members of the care team. Ensure practices of the care team are in accordance with nursing standards local, state, and federal guidelines, and organizational policy. Develop and Enhance your Leadership Skills! Provide clinical supervision to Licensed Practical

of Job To disrupt the traditional wellness point solutions model by growing the revenue and membership of WellSpark Health's products and services. This consists of increasing market awareness of WellSpark Health capabilities, as well as sourcing and adding new clients across multiple sales channels, including direct to employer, through brokers, consultants and associatio

of Position The Care Team Associate II serves as a member of the Care Team in the treatment and care of patients who assists providers with clinical services and administrative tasks to support population health guided best in class care. The position works under the supervision of the Practice Administrator and in collaboration with the Nurse Manager. The Care Team Associ

Participates and supports the health team in direct patient care. Performs duties involving direct patient care as assigned by the physician within the framework of the New York State Nurse Practice Act and AdvantageCare Physicians' policies and procedures. Identifies physical, behavioral, and emotional characteristics typical for the age group of the patient receiving ca

Perform Sales Support functions for Small Group Sales Department that aids in the sales process. Provide technical and administrative support to maximize opportunities for meeting and exceeding new membership sales targets. Prepare new business and renewal proposals for delivery. Gather, review, and analyze information; prepare and deliver reports. Responsibilities Facili

of Position Provide professional nursing care to patients and proactively support efforts to ensure that standards for patient satisfaction, patient safety, and quality of care are maintained, as established by AdvantageCare Physicians. Primary liaison between patients, staff and physicians and support the Advanced Care Model. Organize and provide clinical supervision to t

We are seeking an Internal Medicine or Family Medicine trained physician to join us in pursuit of high quality patient care to provide a full scope of primary care services including but not limited to diagnosis, treatment, coordination of care, preventive care and health maintenance. Responsibilities Review patient's history and perform physical examinations. Evaluate, d

of Position Provide professional nursing care to patients and proactively support efforts to ensure that standards for patient satisfaction, patient safety, and quality of care are maintained, as established by AdvantageCare Physicians. Primary liaison between patients, staff and physicians and support the Advanced Care Model. Organize and provide clinical supervision to t

of Position The Care Team Associate II serves as a member of the Care Team in the treatment and care of patients who assists providers with clinical services and administrative tasks to support population health guided best in class care. The position works under the supervision of the Practice Administrator and in collaboration with the Nurse Manager. The Care Team Associ

We are seeking a Family or Internal Medicine trained physician to join us in pursuit of high quality patient care. Responsibilities Provide a full scope of primary care services including but not limited to diagnosis, treatment, coordination of care, preventive care and health maintenance. Review patient's history and perform physical examinations. Evaluate, diagnose and

of Position Organizes and provides clinical supervision to the patient care team including, but not limited to, delegation of responsibilities, mentoring, evaluating, educating, scheduling and counseling the care team staff. Provides professional nursing care to patients and proactively supports the efforts to ensure that standards for patient satisfaction, patient safety,

of Position The Care Team Associate II serves as a member of the Care Team in the treatment and care of patients who assists providers with clinical services and administrative tasks to support population health guided best in class care. The position works under the supervision of the Practice Administrator and in collaboration with the Nurse Manager. The Care Team Associ