Point32Health

Care Manager ensuring timely care management for members at Point32Health

Care Manager ensuring timely care management for members at Point32Health

The Senior Contract Manager will develop, negotiate, execute, and manage provider contracts for ancillary services, functioning as the point person for provider recruitment and ensuring contract terms align with organizational guidelines. This role involves collaborating on budget development, evaluating cost trends, formulating reimbursement models, and mentoring other team members.

The Behavioral Health Utilization Management Clinician conducts benefit coverage reviews and utilization management according to regulatory guidelines, aiming to ensure clinically appropriate service delivery and support organizational goals. Key duties include adhering to review guidelines, interacting with staff and providers, prioritizing authorization requests, and reviewing various service requests like inpatient admissions and outpatient procedures.

Appeals and Grievance Analyst managing member appeals and grievances at Point32Health

Senior Training Specialist providing training to staff in a healthcare organization

Care Manager – Nursing Field ensuring timely care management for members

Payroll Specialist processing bi-weekly multi-state payroll with Workday

Training Specialist designing and implementing training programs at Point32Health

Actuarial Analyst I supporting financial and actuarial analysis services