Benefits Systems Manager - Healthcare jobs in Las Cruces, NM

Benefits Systems Manager - Healthcare manages the implementation and upkeep of benefits system for managed care and provider data. Monitors systems to ensure medical management needs are met. Being a Benefits Systems Manager - Healthcare ensures fee loading and coding is accurate. Requires a bachelor's degree. Additionally, Benefits Systems Manager - Healthcare typically reports to a head of a unit/department. The Benefits Systems Manager - Healthcare manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Extensive knowledge of department processes. To be a Benefits Systems Manager - Healthcare typically requires 5 years experience in the related area as an individual contributor. 1 to 3 years supervisory experience may be required. (Copyright 2024 Salary.com)

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Care Manager LPN or LVN
  • Collaborative Health Systems
  • Las Cruces, NM FULL_TIME
  • You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

    Position Purpose: Utilizes care coordination tools, criteria and protocols to provide care coordination to lower acuity members with acute and chronic health care needs. Provides education and support in assisting members to achieve optimal level of wellness. Works in the field with member to support compliance with care and treatment plans in collaboration with the interdisciplinary care team. Meets with clients in their homes, work-sites, physician’s or hospital to provide management of services.

    • Perform member interviews to assist with gathering of information
    • Perform follow up with members engaged in case management
    • Facilitate provider contact as needed to coordinate member's care needs. Initiates appropriate referrals and inputs authorizations as needed for members active in case management.
    • Support the identification of high-risk members for disease or case management needs and works with member, physician and other Health care providers to meet the member's individual needs.
    • Identifies and escalates member cases with complex medical needs to Supervisor or Manager.
    • Act as liaison and member advocate between the member/family, physician and facilities/agencies.
    • Coordinates community resources, with emphasis on medical, behavioral, and social services. Applies case management standards, maintains HIPAA standards and confidentiality of protected health information and reports critical incidents and information regarding quality of care issues.
    • Instructs the member on how to access the program resources, suggest and/ or arrange follow-up including mailing of educational materials, contact with community resources, facilitate physician visits.
    • Documents all contacts in the Health Services clinical documentation system.
    • Manage members in disease management program, completing and revising as necessary, the information in clinical documentation system.
    • Ensures compliance with all state and federal regulations as well as Corporate guidelines in day-to-day activities.
    • Meets with clients in their homes, work-sites, physician’s or hospital to provide management of services.
    • Adapts to changes in policies, procedures, new techniques and additional responsibilities.
    • Participates with other Case Managers and Medical Directors in regular or special meetings such as Clinical rounds.
    • Complies with all guidelines established by the Centers for Medicare and Medicaid (CMS) and guidelines set forth by other regulatory agencies, where applicable, and Corporate and department policies and procedures.
    • Identifies potential quality of care issues and appropriately refers to the quality department.
    • Assists in the implementation of specific strategies that improve the quality and outcomes of care.
    • Educates members and facilitates HEDIS gap closure.
    • Performs all other duties assigned.
    • Works under direct supervision of a Registered Nurse
    • Additional Responsibilities: * Travel to inpatient bedside, member’s home, provider’s office, hospitals, etc required with dependable car. May spend up to 70% of time traveling with exposure to inclement weather and normal road hazards. May require climbing multiple flights of stairs to a member's home, provider's office, etc.

    Licenses and Certifications: A license in one of the following is required: Required Other Current unrestricted LPN/LVN state license

    Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.

    Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

    Job Type: Full-time

    Benefits:

    • 401(k)
    • 401(k) matching
    • Dental insurance
    • Health insurance
    • Life insurance
    • Paid time off
    • Vision insurance

    Schedule:

    • 8 hour shift
    • Day shift
    • Monday to Friday

    Education:

    • High school or equivalent (Preferred)

    Experience:

    • clinical: 2 years (Preferred)
    • field: 1 year (Preferred)

    License/Certification:

    • LPN or LVN License (Required)

    Ability to Relocate:

    • Las Cruces, NM: Relocate before starting work (Required)

    Willingness to travel:

    • 75% (Preferred)

    Work Location: On the road

  • 27 Days Ago

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Assistant General Manager
  • Total Management Systems
  • Las Cruces, NM FULL_TIME
  • Do you have the aspiration to be a hotel General Manager? Total Management Systems is looking to find an Assistant General Manager at the Courtyard by Marriott at NMSU to join our growing organization...
  • 1 Month Ago

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Front Office Manager
  • Total Management Systems
  • Las Cruces, NM FULL_TIME
  • Do you find yourself in a leading role when working with others? Are you looking for an opportunity to advance your career in the hotel industry? The Courtyard by Marriott at NMSU is searching for a F...
  • 1 Month Ago

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Healthcare Payroll - Scheduler
  • Genesis HealthCare
  • Las Cruces, NM FULL_TIME
  • Genesis HealthCare is one of the nation's leading providers of healthcare services from short-term to long-term care and a wide variety of living options and professional clinical services. We are cha...
  • 24 Days Ago

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Scheduler - Healthcare
  • The Village at Northrise - Las Cruces, NM
  • Las Cruces, NM FULL_TIME
  • Genesis is one of the nations' leading provider of healthcare services from short-term to long-term care and a wide variety of living options and professional clinical services. We are changing how ca...
  • 10 Days Ago

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National Grazing Lands Coalition - Western Grazing Network: Data Systems Manager
  • National Grazing Lands Coaliti
  • Las Cruces, NM FULL_TIME
  • Western Grazing Lands Network Data Systems Manager Come join the National Grazing Lands Team! In support of livestock producers and grazing lands in the West, we are seeking a Data Systems Manager to ...
  • 17 Days Ago

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0 Benefits Systems Manager - Healthcare jobs found in Las Cruces, NM area

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Housekeeper
  • HHS, LLC
  • Las Cruces, NM
  • Housekeeper/Floor Care Technician Wage: $12/hour Full-time and part-time positions available Day/Evening/Night shifts av...
  • 3/29/2024 12:00:00 AM

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Manager
  • Crunch Fitness
  • Las Cruces, NM
  • Job Description: The Crunch Manager will ensure the members receive the highest quality of service and facilities. He or...
  • 3/29/2024 12:00:00 AM

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Occupational Therapy Assistant PRN Occupational Therapy
  • LifePoint Hospitals
  • Las Cruces, NM
  • Who We Are People are our passion and purpose.?Come work where you are appreciated for who you are not just what you can...
  • 3/29/2024 12:00:00 AM

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Hospice RN Administrator - $10K Sign-On Bonus
  • Curo Health Services
  • Las Cruces, NM
  • Our Company Gentiva Hospice is a member of the Gentiva family - an industry leader in hospice, palliative, home health, ...
  • 3/29/2024 12:00:00 AM

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Housekeeper
  • Hospital Housekeeping Systems
  • Las Cruces, NM
  • Housekeeper/Floor Care Technician * Wage: $12/hour * Full-time and part-time positions available * Day/Evening/Night shi...
  • 3/29/2024 12:00:00 AM

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Baker and Packager Associate
  • Wal-Mart
  • Las Cruces, NM
  • Position Summary... Do you have a knack for helping people, following recipes and organization? Our Bakery/Packager asso...
  • 3/28/2024 12:00:00 AM

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OBGYN RN Clinic Office - FT
  • Community Health System
  • Las Cruces, NM
  • Job Description * Prior experience in physician office setting - Preferred. * Experience assisting with in-office proced...
  • 3/28/2024 12:00:00 AM

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Dentist- Current, Permanent Employees of El Paso VA Health Care System
  • Department of Veterans Affairs
  • Las Cruces, NM
  • Summary This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement ...
  • 3/28/2024 12:00:00 AM

Las Cruces is the seat of Doña Ana County, New Mexico, United States. As of the 2010 census the population was 97,618, and in 2017 the estimated population was 101,712, making it the second largest city in the state, after Albuquerque. Las Cruces is the largest city in both Doña Ana County and southern New Mexico. The Las Cruces metropolitan area had an estimated population of 213,849 in 2017. It is the principal city of a metropolitan statistical area which encompasses all of Doña Ana County and is part of the larger El Paso–Las Cruces combined statistical area. Las Cruces is the economic and...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Benefits Systems Manager - Healthcare jobs
$82,000 to $115,915
Las Cruces, New Mexico area prices
were up 2.5% from a year ago

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