Group Membership Representative I
PacificSource Health Plans - Springfield, MA
Maintain enrolled groups and subscribers, providing direct access by group administrators for assistance with benefits, administration, compliance and billing questions. Promote customer training and service by visiting groups or attending meetings as requested or determined nece...
Behavioral Health Quality Coordinator
PacificSource Health Plans - Boise, ID
Under the supervision of the Behavioral Health Manager and in collaboration with Quality Manager, this position is responsible for design, implementation, and oversight of Behavioral Health (BH) Quality Management program and activities. This position is responsible for identifyi...
PacificSource Health Plans - Boise, ID
This position promotes high quality; cost-effective outcomes by helping selected member populations achieve effective utilization of behavioral health services. The position incorporates a person centered-strength based approach of helping and, applies it to the essential functio...
PacificSource Health Plans - Springfield, MA
Process new groups and current groups with changes, generate group and member documents, and ensure complete and accurate information distribution. Generate final quotes for new groups. Ensure policy and legal compliance. Responsibilities: 1. Determine laws, policies, and codes t...
Customer Service Representative
PacificSource Health Plans - Springfield, MA
Provide excellent customer service primarily by telephone to all PacificSource customers. Assist customers with coverage/claims related questions. Accurately interpret benefits and policy provisions for all PacificSource products. Conduct appropriate research and follow-up for pr...
PacificSource Health Plans - Springfield, MA
Responsible for assisting Credentialing team by obtaining and maintaining critical credentialing data necessary for initial reviews and the monitoring of practitioners and facilities to determine participatory status, thereby supporting the selection of contracting of practitione...
PacificSource Health Plans - Springfield, MA
As directed by the Internal Audit Manager, examine and evaluate the ongoing control processes of the organization and provide timely recommendations for improvement whenever they are identified. Conduct research and analyze department processes and operations. Perform audit proce...
PacificSource Health Plans - Boise, ID
Provide support to the Compliance Officer in the daily operation of the Corporate Compliance Program, communicating and resolving compliance issues related to the organization’s government lines of business and with other administrative compliance requirements. Assists with creat...
PacificSource Health Plans - Springfield, MA
The primary focus of this position will be to assist members who are enrolled in the Condition Support programs to effect positive lifestyle and health-related changes to maximize the quality of life/health and reduce utilization of healthcare resources over time. Collaborate wit...
PacificSource Health Plans - USA
Work Experience: Five years nursing experience with varied clinical experience. Experience in health coaching, disease management, and/or chronic condition management (adults or children) preferred....
PacificSource Health Plans - Bend, OR
PacificSource Health Plans is anything but a typical health plan. We're a growing, independent, not-for-profit organization with a 78-year history and reputation for service excellence. At PacificSource it is our 600+ employees that make a difference. We invest in the communities...
PacificSource Health Plans - Boise, ID
Collaborate with health services team on program development, implementation, and performance of condition management programs designed to improve the health of populations. Assess health risks among the population to stratify members for appropriate interventions, including educ...
PacificSource Health Plans - Springfield, MA
Collaborate with the Wellness Coordinator and other Wellness Specialists, and work independently and as a team on wellness program development, implementation, and organization. Work closely with individual employer groups to understand, develop, and facilitate resolution of empl...
PacificSource Health Plans - Tigard, OR
Collaborate with the Wellness Coordinator and other Wellness Specialists, and work independently and as a team on wellness program development, implementation, and organization. Work closely with individual employer groups to understand, develop, and facilitate resolution of empl...
IT Intern - Microsoft Sharepoint
PacificSource Health Plans - Springfield, MA
Assist with support of our Sharepoint efforts. Responsibilities include assisting with design, integration, and maintenance of the existing Microsoft Office 2007 SharePoint farm. Specific projects could include: Improve existing SharePoint features and applications. Develop new S...
PacificSource Health Plans - Springfield, MA
Provide data analysis for PacificSource to achieve the goals and initiatives identified in our Strategic Plan. Primary subject of analytic support will be related to analysis of cost and utilization of health services, in support of large employer reporting, financial modeling fo...
PacificSource Health Plans - Springfield, MA
Responsible for leading, directing, and energizing the organization using Lean principles, systems, and tools to positively impact customer satisfaction, quality, performance and development of a culture of continuous improvement. Deliver mentoring and training of Lean principles...
IT Intern - Dynamo Developer - SQL focus
PacificSource Health Plans - Springfield, MA
Assist in the implementation of new capability on the Dynamo platform. Develop new workflows, reports, and documents using the SQL query based interface of the Dynamo system. Provide support of the Dynamo system to the Health Services community. Qualifications: Must be a computer...
PacificSource Health Plans - Helena, MT
Serve as the senior member of the Montana team with responsibility for all health plan activities in the state. Manage and supervise local office functions and personnel. Serve as senior leader for issues related to media, legislative, regulatory, business, key provider interacti...
PacificSource Health Plans - Springfield, MA
The Project Manager is responsible for managing the entire life cycle of application development, ad-hoc projects and ensuring that projects meet or exceed the success criteria as set forth by the business users. A major part of this position is to provide a proactive interface b...