... required. Recent managed care experience preferred, familiarity with Federal and State Medicaid regulations, Medicare, national accreditation standards, and HEDIS preferred, experience with long term care and supervisory experience preferred. CLINICAL OPERATIONS DEPARTMENT Member Service Navigator The role of the Member Service Navigator is to assist health plan members in navigating ...

... policies, practices, procedures or specific instructions and within federal and state statutes and regulations. Performs cashiering duties such as collection of cash, check, or credit card payments for all collectible services. Essential Functions: - Assists with inputting patient and prescription information to produce labels and to assist in prescription filling ...

... organization's policies, procedures, practices, labor agreements, and relevant Federal and State laws. Supports compliance and Principles of ... and exhibits ethics and integrity. Adheres to applicable federal and state laws and regulations, accreditation and licensing ... verifies, and monitors specific ledger accounts - Computes Federal and State taxes; prepares and transmits payments to ...

... nursing facilities . Assists with coordinating services with federal and state programs, and other community services to the member. Promotes effective healthcare utilization, monitors health care resources and assumes a leadership role within the Interdisciplinary Care Team (ICT) to achieve optimal clinical and resource outcomes. ...

... required. Recent managed care experience preferred, familiarity with Federal and State Medicaid regulations, Medicare, national accreditation standards, and HEDIS preferred, experience with long term care and supervisory experience preferred. Clinical Operations/Pharmacy Manager This position manages, provides expertise, and to supports AlohaCare?s clinical operations and pharmacy management department, which includes supervising ...