Have an ASN/BSN. Willing to apply for any state licensure the organization requests. 1 year of experience in a Managed care organization (MCO) or Third party administrator (TPA) Become knowledgeable of URAC requirements for CM accreditation. Have reliable high-speed internet service at home.
Experience working in healthcare, PBM, specialty pharmacy, or healthcare consulting. 7 years of senior level experience with IBM i, iSeries, or AS/400 Strong knowledge of multiple LPAR and servers maintenance and patch process.
Minimum 1 year healthcare/health plan experience. Minimum 1 year HEDIS experience and/or knowledge. Solid knowledge of managed care requirements related to clinical quality. Research and detail oriented, excellent proof reading skills. Reliable internet connection (virtual)