Providence
Neighborhood Health Plan of RI Jobs in Providence
19 Neighborhood Health Plan of RI jobs in Providence, Rhode Island found on Monster.
Summary The Configuration Analyst I position is a senior level position which requires strong analytical and problem solving skills as well as solid industry knowledge and sufficient system testing and configuration experience. . Qualifications: Required: · Bachelor’s degree, and/or 5+ years of experience and background to equate to the degree in technology, management or clinical discipline · Has...
Overview: The Clinical Management Nurse works collaboratively with the health care team to determine appropriateness of medical services, procedures and care setting for Neighborhood members by reviewing and evaluating medical information and individual needs and applying established national criteria and Neighborhood plan guidelines in order to ensure quality, cost effective care, and the transit...
Qualifications: Required: · B.S. in business or business related field · 3-5 years of relevant professional experience · Demonstrated experience leading workgroups on a diverse array of financial analysis · Database and spreadsheet proficient (Excel) · Independent work style · Strong interpersonal skills, with the ability to interact effectively with senior managers, clients and staff · Highly mot...
Overview: The Medical Case Manager works collaboratively with the health care team to manage and coordinate care for a specific population of members whose needs represent high clinical and social risk in order to ensure quality and cost-effective member-centered care. Qualifications: Required: · Licensed RN, State of RI · BS Degree or Certification as a CM or RN with 3 years clinical practice · 3...
The Behavioral Health Project Specialist will be responsible for coordinating the behavioral health vendor relationship with a focus on the implementation and oversight of new and existing lines of business. The Behavioral Health Project Specialist will also be responsible to identify, implement and measure utilization and quality improvement opportunities to ensure members are receiving clinicall...
POSITION TITLE: Financial Analyst II DEPARTMENT: Financial Services REPORTS TO: Manager of Financial Analysis HOURS: 37.5 FLSA: Exempt SALARY GRADE: 11 Qualifications: Required: - Spreadsheet proficient (Excel) - Independent work style - Highly motivated - Takes ownership of project/work - Self-starter - Ability to recommend process/job design improvements - Seeks solutions - makes things happen -...
This position supports the Medical Expense Management (MEM) leadership team in the identification, evaluation, quantification and implementation of multiple medical expense savings initiatives across departments and in alignment with Neighborhood’s goals and objectives. Qualifications: Required: - Bachelor’s degree in a related field or an Associate’s degree and sufficient work experience to equat...
This Pharmacy Technician reports to the Manager of Pharmacy Operations and is responsible for conducting and coordinating multiple facets of the prescription drug prior authorization (PA) process and coordination and completion of administrative tasks associated with the Pharmacy Department operation. The duties associated with this position include PA order entry, updating PA’s within the Pharmac...
DEPARTMENT: Business and Technical Services REPORTS TO: Manager of Infrastructure and Support HOURS: 37.5 FLSA: Exempt SALARY GRADE: 12 Overview: The systems administrator has responsibility for the support and maintenance of NHPRI’s server environment. Qualifications: - Bachelor’s degree in Information Systems or a related area and at least 3+ years of experience in Information Systems; - Minimum...
This role requires a Project Manager with strong leadership, communication and analytical skills who is an expert in project management. He/she will be responsible for the coordination and completion of projects and will oversee all aspects of projects, sets deadlines, assigns responsibilities, and monitors and summarizes progress of projects. The Project Manager will prepare reports for managemen...
DEPARTMENT: Executive REPORTS TO: Director of the Marketing and External Affairs HOURS: 37.5 FLSA: Exempt SALARY GRADE: 12 Overview: The Project Coordinator for the office of the CEO will provide administrative and project support to the Chief Executive Officer (CEO) and Senior Leadership Team (SLT). He/she is a key liaison between Office of the CEO, Board Members, state and federal officials, and...
DEPARTMENT: Operations REPORTS TO: Claims Operations Team Lead HOURS: 37.5 FLSA: Non-Exempt SALARY GRADE: 9 Overview: The role of the Claims Analyst is to ensure that claims are processed according to state and federal regulations and meet NHPRI’s contractual obligations. Qualifications: Required: - High school graduate or equivalent - Demonstrated knowledge of industry standard coding and medical...
The role of the Medical Consultant is to provide clinical support to the Director of Pharmacy, Associate Medical Directors, and Chief Medical Officer in providing clinical input to Medical Review, Expense Management, and Medical Management activities. Qualifications Required: - Physician, unrestricted license in the State of Rhode Island; no restrictions in any state - Board certified in a primary...
Chief Medical Officer Neighborhood Health Plan of Rhode Island Providence, RI The Chief Medical Officer (CMO) position at Neighborhood Health Plan of Rhode Island (Neighborhood) provides the opportunity for a physician leader to impact and influence the care of vulnerable patient populations. The CMO will lead the development of all of Neighborhood’s Clinical Programs – including quality managemen...
DEPARTMENT: Business and Technical Services REPORTS TO: Manager of BI and Development HOURS: 37.5 FLSA: Exempt SALARY GRADE: 14 Overview: The role of the Data Architect is to create a long-term, enterprise-wide plan to integrate all business systems and workflows to enhance Business Intelligence for the entire organization. The Data Architect will work closely with the Developers and Analysts to u...
Neighborhood Health Plan of Rhode Island (Neighborhood) is seeking a senior level Human Resources professional with a broad and deep background in all aspects of Organization Development (OD)/ and Human Resources (HR). The ideal candidate for this position will have a proven track record of organizing and growing the ODHR function to be viewed as a customer-oriented strategic business partner. S/h...
Job Description POSITION TITLE: Product Lead DEPARTMENT: Business Development REPORTS TO: Director of Business Development HOURS: 37.5 FLSA: Exempt SALARY GRADE: 12 Qualifications: Required: * Bachelor’s degree or sufficient work experience to equal the degree * 3+ years of related analytical/financial experience * 3+ years of managed care/health care experience required * Strong interpersonal ski...
POSITION TITLE: Medical Case Manager DEPARTMENT: Medical Management REPORTS TO: Medical Management Team Lead HOURS: 37.5 FLSA: Exempt SALARY GRADE: 12 Overview: The Medical Case Manager works collaboratively with the health care team to manage and coordinate care for a specific population of members whose needs represent high clinical and social risk in order to ensure quality and cost-effective m...
POSITION TITLE: Medical Management Team Lead (Clinical Programs) DEPARTMENT: Medical Management REPORTS TO: Manager of Care Management, Manager of Clinical Management HOURS: 37.5 FLSA: Exempt SALARY GRADE: 13 Overview: The Team Lead of Medical Management provides oversight for specific care management or medical review programs/activities and works collaboratively with the Health Care Team to mana...
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©2013 Monster - All Rights Reserved U.S. Patents No. 5,832,497; 7,599,930 B1; 7,827,125 and 7,836,060 MWW - Looking for Monster Cable? - V: 2013.1.5.22-302