Group Health Cooperative

Position PurposeWith minimal supervision; assists in performing health screenings on members to evaluate a members medical and social needs for potential enrollment into the case management program. Relates effectively with others for continuity of care; maintains satisfactory relatio

Position PurposeWith minimal supervision; assists in performing health screenings on members to evaluate a members medical and social needs for potential enrollment into the case management program. Relates effectively with others for continuity of care; maintains satisfactory relatio

Position PurposeWith minimal supervision the Inpatient Utilization Management Specialist assesses plans directs and conducts utilization reviews discharge planning and transition of care to optimize health care outcomes for our members. Reviews are conducted using evidence-based clini

Position PurposeWith minimal supervision the Inpatient Utilization Management Specialist assesses plans directs and conducts utilization reviews discharge planning and transition of care to optimize health care outcomes for our members. Reviews are conducted using evidence-based clini

Position PurposeTo support and help implement quality improvement initiatives at the direction of the QI Manager through coordination and collaboration both externally and internally. Help improve quality metrics through process improvement.Essential Position FunctionsParticipate in Q

Position PurposeTo support and help implement quality improvement initiatives at the direction of the QI Manager through coordination and collaboration both externally and internally. Help improve quality metrics through process improvement.Essential Position FunctionsParticipate in Q

Position PurposeThe Appeals Specialist will be responsible for the appeals process from receipt to resolution for both provider appeals and member appeals grievances and complaints. This position will research and resolve complex issues related to claims and enrollment provider paymen

Position PurposeThe Appeals Specialist will be responsible for the appeals process from receipt to resolution for both provider appeals and member appeals grievances and complaints. This position will research and resolve complex issues related to claims and enrollment provider paymen