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Social Worker, Population Health
Social Services · Brighton Health Plan Solutions · New York, NYAbout The Role At Brighton Health Plan Solutions (BHPS), we’re creating something new and different in health care, and we’d love for you to be part of it. Based in New York City, BHPS is a rapidly growing, entrepreneurial health care enablement ...4 days ago on The ResumatorTools -
Customer Service Representative
Customer Service · Brighton Health Plan Solutions · Melville, NYAbout The Role MagnaCare is seeking Customer Service Representatives to assist members, physicians, hospitals, and other healthcare providers with member benefits, eligibility, claims inquiry, claim reconsiderations and appeals. This job descri...5 days ago on The ResumatorTools -
Project Manager, Compliance
Management & Exec · Brighton Health Plan Solutions · Westbury, NYAbout The Role Brighton Health Plan Solutions, LLC is a wholly owned subsidiary of a highly regulated health insurance company (“Parent”). The Project Manager - Compliance oversees and coordinates a wide range of compliance and policy requirement...2 weeks ago on The ResumatorTools -
Appeals Manager
Management & Exec · Brighton Health Plan Solutions · Westbury, NYAbout The Role The Appeals Manager is responsible managing Appeal Supervisors and identifying opportunities for enhancements and changes to workflows to increase effectiveness and productivity of the team. Provides on-going feedback to the team a...2 weeks ago on The ResumatorTools -
Utilization Management Nurse, Concurrent Review
Healthcare · Brighton Health Plan Solutions · Chapel Hill, NCAbout The Role BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs daily medical necessity reviews. This position reports to the Director, Clinical Programs. This job description is not designed...3 weeks ago on The ResumatorTools -
Utilization Management Nurse, Prior Authorization
Healthcare · Brighton Health Plan Solutions · Chapel Hill, NCAbout The Role BHPS provides Utilization Management services to its clients. The Utilization Management Nurse - Prior Authorization performs medical necessity reviews on prior authorization requests in accordance with national standards, contract...3 weeks ago on The ResumatorTools -
Utilization Review Nurse, Quality & Appeals
Healthcare · Brighton Health Plan Solutions · Chapel Hill, NCAbout The Role BHPS provides Utilization Management services to its clients. The Utilization Review Appeals Nurse performs daily appeal reviews and clinical quality oversite. This position reports to the Clinical Program Manager. This job descri...3 weeks ago on The ResumatorTools -
Director, Applications Support
Management & Exec · Brighton Health Plan Solutions · Westbury, NYAbout The Role The Director of Applications Support has responsibility for strategic development and execution of a quality program for system configuration and changes. The role is responsible for establishing a quality dashboard and implement t...3 weeks ago on The ResumatorTools -
Senior Analyst, Provider Network Analytics
Jobs · Brighton Health Plan Solutions · United StatesAbout The Role The Senior Analyst – Provider Network Analytics will be an enthusiastic team player, providing analytical support to Network Management and Contracting. This role will be deeply involved in the analytical processes that drive execu...4 weeks ago on The ResumatorTools -
Senior Enterprise Business Analyst
Jobs · Brighton Health Plan Solutions · New York, NYAbout the Role We are seeking a passionate, results-oriented Senior Enterprise Business Analyst who can collaborate effectively with internal and external stakeholders to analyze, define and manage requirements to launch new product & services....Over 4 weeks ago on The ResumatorTools