• Location: Beech Island, SC
• Type: Contract
• Job #32172

Network Management Specialist

Responsibilities:

• Assesses network needs, analyzes network composition, and using organization databases, application of regulatory requirements, accreditation entities and other resources, recruits individual, group and/or organizational providers to meet network adequacy standards and assure quality network.
• Conducts and coordinates contracting and amendment initiatives.
• Provides issue resolution and complex trouble shooting for providers.
• Conducts provider education and provider relation activities, providing necessary written materials.
• Conducts administrative provider site visits and coordinates report development and completion according to contractual requirements or ad hoc requests.
• Coordinates Public Policy Research Center (PPRC) activities to assure maintenance of current credentialing status, and evaluation and appropriate actions of quality of care issues and complaints against providers.
• Conducts and manages ongoing audits of provider compliance with Magellan policies and procedures as well as contractual obligations for multiple customers.
• Develops work plans to address audit requirements.
• Works with management to draft, clarify and recommend changes to policies which impact network management.

Must Have Hard Skills:

• Customer service experience
• Intermediate knowledge of Microsoft Office Suite, specifically Excel. Strong presentations skills using PowerPoint. Minimum
• Provider recruitment and contracting experience
• Must be a United States Citizen

Nice to Have Hard Skills:

• Sales experience
• Knowledge of National Committee for Quality Assurance (NCQA) requirements.
• Military experience/ Background
• Bilingual in Spanish and English

Must Have Soft Skills:

• Verbal skills

Nice to Have Soft Skills:

• Independent worker

Experience:

• Network 1+ years

Education:

• Bachelors (Preferred)

• Location: Beech Island, SC
• Remote: Remote
• Type: Contract
• Job #31875

Senior IT Analyst (REMOTE)

Responsibilities:

• Independently participate in requirements documentation, business systems configuration and defining/execution of acceptance criteria.
• Document issues and participate in their resolution.
• Work closely with development and business teams to understand business requirements.
• Translate business needs into high-level technical specifications and design.
• Identify gaps and ensure deployment of solutions.
• Support business-critical systems using mature IT and software engineering practices.
• Develop, deploy, and execute test strategies.
• Work with team to ensure the highest quality product delivery.
• Work closely with cross functional teams and across boundary organizations to gather requirements, define solutions, implement new tools and process, and provide ongoing support to these teams.
• Test applications and products at the user level, both manually and with automated tools.
• Develop deep understanding of the applications that he/she/they support.
• Communicating cross-functionally and across management levels in formal and informal settings.
• Track multiple test executions simultaneously and synthesize the results.

Required Skills:

• 3+ years related experience including developing requirements, designing and executing test cases in IT.
• Experience with QA methodology and problem solving techniques/tools.
• Detail-oriented person who is passionate about quality and is enthusiastic about the new technology offered to customers.
• Demonstrated software testing experience.
• Excellent written and oral communication skills.
• Meticulous attention to detail; the ability to juggle several tasks in parallel without lowering your quality bar.
• Experience with analytical programming languages such as SQL.
• Ability to thrive in ambiguity and rapid change.
• Experience with process flow diagrams.
• Experience with applying Agile Methods.
• Experience with Problem Solving Techniques.
• Hands-on experience running queries and creating reports.
• Ability to understand technical specifications and analyze log files.
• Experience working with industry standard claims, billing or EHR systems.

Preferred Skills:

• Edifecs Experience
• Experience with gathering business requirements

Experience:

• IT

Education:

• Bachelor’s

• Location: Beech Island, SC
• Remote: Remote
• Type: Contract
• Job #31874

Senior Software Engineer (REMOTE)

Responsibilities:

• Analyzes problems and program in two or more programming language/platforms.
• Understands and develops functional and non-functional requirements for a system.
• Works with multiple programming frameworks.
• Develops, tests, and maintains code using software development methodology and appropriate technologies for the system being used.
• Integrates systems to databases and other applications using middleware such as SnapLogic and consume or produce SOAP or REST based services, etc. Agile, DevOPS and Cloud.
• Possesses proficiency in automated testing strategies, including TDD.
• Understands advanced concepts of Containers, Micro-Services, Continuous Integration.
• Understands Cloud computing concepts and how to build Cloud deployable application.
• Performs load and performance testing on the application and do regular performance tuning.

Required Skills:

• 3+ years of programming experience.
• Strong working knowledge of modern programming languages including JavaScript, Java, Swift etc.
• Critical thinker.
• Demonstrated problem solving techniques.
• Strong verbal and written communication skills.

Required Experience:

• IT Programming 3+ Years

Education:

• Bachelor’s: Computer and Information Science (Preferred)