
1001 - 5000 employees
💼 Consulting
🛡️ Insurance
🏥 Healthcare
💰 $101M Private Equity Round on 2004-01
Consulting • Insurance • Healthcare
Magellan Health is a leading healthcare management company that provides a range of services, including behavioral health, pharmacy management, and employee assistance programs. The company focuses on delivering high-quality care and support to individuals and families, particularly those in military and community settings. Magellan Health emphasizes personalized service and innovative solutions to improve health outcomes and enhance the overall patient experience.
🔥 21 hours ago
🌶️ New Mexico – Remote
💵 $50.2k - $75.3k / year
⏰ Full Time
🟡 Mid-level
🟠 Senior
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1001 - 5000 employees
💼 Consulting
🛡️ Insurance
🏥 Healthcare
💰 $101M Private Equity Round on 2004-01
Consulting • Insurance • Healthcare
Magellan Health is a leading healthcare management company that provides a range of services, including behavioral health, pharmacy management, and employee assistance programs. The company focuses on delivering high-quality care and support to individuals and families, particularly those in military and community settings. Magellan Health emphasizes personalized service and innovative solutions to improve health outcomes and enhance the overall patient experience.
• Coordinate care for individual clients and identified populations through assessment, care planning, implementation, coordination, monitoring, and evaluation • Perform duties virtually or face-to-face based on contractual requirements • Promote appropriate use of clinical and financial resources to improve quality of care and member satisfaction • Assist with orientation and mentoring of new team members as appropriate • Provide care coordination to members with behavioral health conditions requiring intensive interventions and oversight • Conduct in-depth health risk and comprehensive needs assessments covering psychosocial, physical, medical, behavioral, environmental, and financial parameters • Communicate and develop care plans and serve as point of contact to ensure services are rendered appropriately • Implement, coordinate, and monitor strategies to improve members' and families' health and quality-of-life outcomes • Develop, document, and implement plans addressing social, physical, mental, emotional, spiritual, and supportive needs • Advocate for members by identifying and addressing gaps in care • Monitor plans of care and measure intervention effectiveness • Review plans regularly to identify care gaps and trends • Collect clinical path variance data to identify improvement opportunities • Work with members and interdisciplinary care plan teams to adjust plans of care • Educate providers, staff, members, and families regarding care coordination and health strategies • Facilitate team-based, cost-effective delivery of quality care and services • Collaborate with members, caregivers, legal representatives, physicians, care providers, and ancillary support services • Assist members with questions and concerns regarding care, providers, and delivery systems • Maintain professional relationships with inpatient, outpatient, and community stakeholders • Generate reports according to care coordination goals • Comply with position-specific security responsibilities, legal, regulatory, contractual, and internal policy requirements
• 3–5 years' experience in Social Work, Nursing, Healthcare-related field, or relevant experience in lieu of degree • Experience in utilization management, quality assurance, home or facility care, community health, long-term care, or occupational health • Experience analyzing trends based on decision support systems • Business management skills, including cost/benefit analysis, negotiation, and cost containment • Knowledge of referral coordination to community and private/public resources • Detailed knowledge of cost-effective care coordination and data interpretation • Ability to make decisions requiring significant analysis and investigation • Ability to determine courses of action in complex situations not addressed by existing policies or protocols • Ability to maintain complete and accurate enrollee records • Effective verbal and written communication skills • Ability to work with clinicians, hospital officials, and service agency contacts • GED or high school education required • Valid in-state driver's license required • CCM, LCSW, or RN certification/licensure preferred
• Short-term incentives may be available • Comprehensive benefits package • Health, life, voluntary and other benefits • Benefits and perks supporting physical, mental, emotional and financial wellbeing • Tobacco-free workplace
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