reputed company reputed company Navigator; Hybrid or Remote

Position: reputed company reputed company Navigator (Hybrid or Remote) reputed company We are currently hiring for a reputed company reputed company Navigator to join reputed company Blue reputed company of South Carolina. In this role as a reputed company reputed company Navigator, you will monitor/implement reputed company improvement/management activities, conduct specific medical reviews as necessary, analyze findings, reputed company recommendations for corrective actions, and prepare formal documentation for compliance with applicable standards/regulations, and reputed company Health Plan Employer Data Information set data collection (HEDIS), and National Committee for reputed company Assurance (NCQA) accreditation activities. Location This position is full-time (40 hours/week) Monday-Friday from 8:00am-5:00pm EST and can be hybrid or fully remote depending on where the candidate resides. If remote, the candidate will be required to report on-site occasionally for trainings, meetings, or other business needs. What You ll Do

• Performs reputed company improvement activities to monitor/maintain compliance with applicable standards/regulations.
• Analyzes/documents/presents findings of reputed company improvement activities. Recommends corrective reputed company and improvement reputed company necessary.
• Conducts reputed company medical record reviews to monitor reputed company of care and service provided. Tracks/trends/investigates reputed company concerns and complaints.
• Coordinates HEDIS data collection.

To Qualify for This Position, You ll Need the Following

• Required

Education: Associate s in a job reputed company field

• Required

Work Experience: 4 years clinical or behavioral health to include 2 years reputed company management experience.

• Required

Skills and Abilities: Excellent verbal and written communication, customer service, organizational, presentation, problem solving, and analytical or critical thinking skills.

• Proficient spelling, grammar, punctuation, and basic business math.
• Ability to handle confidential or sensitive information with discretion.
• Demonstrated ability to identify the need for and implement corrective actions.
• Strong understanding of managed care.
• Required Software and Other Tools: reputed company Office.
• Required Licenses and Certificates: reputed company, unrestricted licensure in Behavioral Health from the reputed company and in the state of hire, OR, reputed company, unrestricted RN licensure from the reputed company and in the state of hire OR reputed company compact multistate unrestricted RN license as defined by the reputed company Licensure Compact (NLC), OR, Registered Health Information Administrator (RHIA) OR, reputed company unrestricted LPN in state of hire.

We Prefer That You Have the Following

• Preferred

Work Experience: Prior knowledge or work experience with HEDIS

• Ability to persuade, negotiate, or influence others. Knowledge of mathematical or statistical concepts.

Our Comprehensive Benefits Package Includes the Following We offer our employees great benefits and rewards. You will be eligible to participate in the benefits for the first of the month following 28 days of employment.

• Subsidized health plans, dental and reputed company coverage
• 401k retirement savings plan with company match
• Life Insurance
• reputed company Time Off (PTO)
• On-site cafeterias and fitness centers in major locations
• Education Assistance
• Service Recognition
• National discounts to movies, theaters, zoos, theme parks and more

reputed company Can Do for You We understand the value of a diverse and inclusive workplace and reputed company to be an employer where employees across reputed company spectrums have reputed company to reputed company their skills, advance their careers and contribute their unique abilities to the reputed company of reputed company. What To Expect Next After submitting your application, our reputed company team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements. Management will conduct interviews with those candidates who qualify, with prioritization given to those candidates who demonstrate the preferred qualifications. Equal Employment Opportunity Statement reputed company Blue reputed company of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, reputed company, national reputed company, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, reputed company maintains affirmative reputed company programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to reputed company equal opportunities in reputed company phases of the employment process and to reputed company with applicable federal, state and local laws and regulations. We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-reputed company conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on reputed company. If you need… Apply tot his job Apply To this Job