Demonstrate commitment and behavior aligned with the philosophy, mission, values and vision of Network Health. Appropriately apply all organizational, regulatory, and credentialing principles, procedures, requirements, regulations, and policies. Enters authorization/pre determination requests into information system according to Network Health policies, procedures and des

Screens candidates for case management and when appropriate completes assessments, care plans with prioritized goals, interventions, and timeframes for re assessment using evidence based clinical guidelines. Evaluates and determines member needs based on behavioral health clinical information such as diagnosis, disease progression, and other behavioral therapies. Reviews

Recommends and meets annual department goals, initiatives and objectives. Anticipates change and makes adjustments based upon organization strategic plans. Ensures department activities are efficient and effective. Manages day to day operations of credentialing department and associates, assigns workloads and manages responsibilities such as hiring, training, staffing cov

Develops, tests, and maintains data interfaces between business data sources in accordance with departmental and professional standards. Performs analysis, design, coding, and maintenance of data imports and extracts. Develops, tests, and implements data change scripts to support the claims processing system. Consults with Business Quality Analysts, Developers, Engineers,

Screens candidates for case management and when appropriate completes assessments, care plans with prioritized goals, interventions, and time frames for re assessment using evidence based clinical guidelines. Evaluates and determines member needs based on clinical or behavioral information such as diagnosis, disease progression, procedures and other related therapies. Rev

Network Health's success is rooted in its mission to enhance the life, health and wellness of the people we serve. It drives the decisions we make, including the people we choose to join our growing team. Network Health is seeking an Enrollment Specialist. This individual is responsible for assisting with all enrollment, disenrollment, fulfillment, reconciliation and rela

Network Health's success is rooted in its mission to enhance the life, health and wellness of the people we serve. It drives the decisions we make, including the people we choose to join our growing team. Network Health is seeking a Enrollment and Business Analysis Integration Manager to lead our Enrollment team. This individual is responsible for directly managing our en

Network Health's success is rooted in our mission to enhance the life, health and wellness of the people we serve. It drives the decisions we make, including the people we choose to join our growing team. Network Health is seeking a Member Experience Supervisor who will be a key member of our supervisor team to support the overall day to day operations of the Member Exper

Demonstrate commitment and behavior aligned with the philosophy, mission, values, and vision of Network Health. Appropriately apply all organizational, regulatory, and credentialing principles, procedures, requirements, regulations, and policies. Utilize real time adherence and scheduling software to determine the proper shift coverage by adjusting resources to accommodat

Develops, tests, and maintains data interfaces between business data sources and the various stages in the Enterprise Data Warehouse in accordance with departmental and professional standards. Performs analysis, design, coding, and maintenance of data imports and extracts. Consults with Business Quality Analysts, Developers, Engineers, DBAs, key departmental stakeholders,