Clever Care는 우리가 섬기는 지역사회에 속한 회원이 복잡한 의료 서비스 체계를 이해하도록 돕고자 설립되었습니다. 당사는 다문화 맞춤 의료 솔루션을 제공해 드릴 때 회원님께서 이해하실 수 있는 언어로 필요한 서비스에 더 잘 접근하실 수 있도록 최선을 다하고 있습니다. 당사는 동양과 서양 의학의 이점을 결합한 플랜을 제공함으로써 회원님의 건강과 웰빙에 대한 약속을 이행하고 있습니다.
Clever Care offers our associates medical, dental and vision plans, as well as Health Care and Dependent Care reimbursement accounts, life insurance, disability, and accident coverage.
Our competitive 401(k) plan includes a generous company match and vesting schedule.
Full time employees are eligible for paid vacation days and sick leave hours. Clever Care observes ten paid holidays per year.
We are looking for people that are as excited as we are to help build a platform that empowers our members and connects Eastern and Western medicine to provide comprehensive health solutions.
Promote the quality and cost effectiveness of medical care by applying clinical acumen and the appropriate application of policies and guidelines to emergent/urgent and continued stay reviews.
The UM/CM Department Coordinator provides support to the utilization and case review process. The coordinator works collaboratively with all team members of Utilization and Case Management department.
Responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion.
The Recovery Resolution Supervisor will work with the Director of Medicare Operations on researching issues to determine feasibility of reducing medical costs through prospective solutions of claim system processes and claim business rules.
The Medicare Operations Business Analytics Manager is an opportunity to lead complex analytics projects and initiatives for Clever Care Health Plan’s Medicare Operations Unit.
Under close supervision, Claims Examiner I process non-complex paper or electronic claims, handling from inception to conclusion within established authority and guidelines.
Internally known as the Broker Support Specialist in Sales Operations team with ongoing daily job responsibilities to manage key action items, special project activities/initiatives, and deadlines.
The VP will be an integral part of, and an essential business partner, to the executive team and company as a whole, by building and maintaining a link between the company’s strategic goals and HR programs.
The Care Management Coordinator assists the Director of SNP Programs and department staff with coordinating, planning, tracking, managing, and ensuring timely implementation of all projects that flow through the SNP Program department.
This Analyst / Senior Analyst will have a measurable impact on Clever Care’s success while also having a front-row seat to learn and observe how a growth healthcare services company is built and scaled.
The Accounting Manager will be responsible for the month-end closing, account reconciliation and profit and loss reporting.
The Special Needs Plan (SNP) Program Case Manager provides a holistic care model which involves collaboration with members and their families, caregivers, and providers.
As a Data Analyst at Clever Care Health Plan, you will be part of a fast-paced, knowledgeable and energetic Data and Analytics team that continuously adapts and expands our data ecosystem.
The Provider Dispute Resolution and Appeals Specialist (“Specialist”) is responsible for processing provider appeals and disputes accurately and timely.
Responsible for assisting in creating and maintaining corporate approved letters using Napersoft, Word, and SQL.
works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential.
The Medicare Enrollment Supervisor serves as a proxy for the Manager of Enrollment and Reconciliation, overseeing the activities and personnel of the Enrollment department while ensuring its processes operate smoothly.
Under the direction of the Claims Manager, the Claims Examiner III reviews and adjudicates complex or specialty claims, submitted either via paper or electronically.
The Agency Account Executive is responsible for helping the regional teams to achieve Clever Care’s established Medicare enrollment objectives in their assigned language segments, by working with the Regional Managers and Field Agency Leaders to drive enrollments through contracted Agencies and Agents.
Responsible for creating and maintaining eligibility records and addressing any concerns related to member enrollment.
Member Advocates are the main point of contact at Clever Care; interfacing with members, prospective members, providers, brokers, and vendors.
The consultant will educate prospective members on Clever Care products and enroll into product of choice over the phone or other sales enrollment channels.
This role supports day-to-day network development activities including managing key action items, special project initiatives, and deadlines.
Clever Care of Golden State는 Medicare 계약을 수반하는 HMO 보험입니다. Clever Care of Golden State 가입은 계약 갱신에 달려 있습니다.
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