Employment Opportunities at Gateway Health Plan®
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Gateway Health Plan®
Human Resource Department
US Steel Tower, Floor 41
Pittsburgh, PA 15219
| Job ID: |
54621 |
| Job Title: |
Administrative Assistant |
| Dept: |
Pharmacy Department |
| Part/Full Time: |
Full Time |
| Work Hours: |
8:30 a.m. - 4:45 p.m. |
| Standard Hours: |
37.5 |
| Location: |
Pittsburgh |
| Date Posted: |
6/19/2008 12:00:00 AM |
| Duties: |
Under limited direction, performs standard and advanced secretarial, duties to the assigned the Director of Pharmacy Services and divisional associates. Assures the timely and accurate completion of all assignments to enhance the efficiency and effectiveness of the principal in meeting operational objectives. Responsibilities include typing, word processing, proofreading, handling phone calls, maintaining and organizing files, copying, reviewing and distributing mail, greeting visitors, ordering supplies, scheduling calendars, review of invoices, preparation of expense reports, coordinating special projects and making travel arrangements. Organizes and expedites flow of work.
Disposes of matters of a routine nature to conserve director and divisional associate's time. Collects information needed by director for conferences and reports.
Arranges meetings and transcribes/distributes workgroup and other meeting minutes as directed. Promotes a culture of performance excellence departmentally by: enhancing job skills through quality process improvement and tools training / certification; participating in process and operational improvement initiatives; building and maintaining effective relationships throughout organization. |
| Qualifications: |
REQUIRED: High school diploma or GED. Minimum of two (2) to three (3) years secretarial or administrative experience. PREFERRED: General knowledge of programs, policies and procedures administered within the assigned area. Excellent typing, word processing and proofreading skills as well as demonstrated proficiency in various software applications. Periodic training to upgrade and obtain new skills in secretarial field. Above average organization and communication skills. Possess tack, the utmost integrity in the discreet handling of confidential information and professionalism in responding to customers of the area and other persons contacting the area. Highly adept at prioritizing and addressing multiple assignments efficiently and effectively.
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| Job ID: |
54598 |
| Job Title: |
Member Service Rep |
| Dept: |
Member Services Department |
| Part/Full Time: |
Full Time |
| Work Hours: |
8:30 a.m. - 4:45 p.m. |
| Standard Hours: |
37.5 |
| Location: |
Pittsburgh |
| Date Posted: |
6/13/2008 12:00:00 AM |
| Duties: |
Provide prompt, courteous and professional response to members, received via telephone, e-mail, mail, fax or in-person for one or more lines of business, utilizing appropriate policies and procedures, approved scripts and training materials. Make outbound calls for various assigned projects (welcome calls, surveys, call-backs, etc.). Document all member contacts on member record using standardized documentation format. Route inquiries, outside of level of expertise, to appropriate departments and follows-up on issue through completion. Maintain minimum standards as follows: 50+ calls answered per day; Average after call work (ACW) or 1 minute per call; Personal AUX (unavailable) time of 30 minutes per day; Average ring time of 6 seconds per call; Average quality monitoring score of 94% per month.
Incumbent has the sole responsibility to identify, define and implement immediate solutions, within company guidelines and policies, to any and all problems arising from member contacts.
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| Qualifications: |
REQUIRED QUALIFICATIONS: Associates Degree or High School Diploma/GED and one (1) year experience in customer service or healthcare.
PREFERRED QUALIFICATIONS: One (1) year experience in a call center, customer service or healthcare. Computer skills with a good working knowledge of MS Office programs. Ability to deal with a diverse and challenging member population. Ability to respond professionally when dealing with confrontational individuals and situations. Keyboarding and data entry skills. Medical terminology knowledge. Organizational skills. Strong written and verbal communication skills.
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| Job ID: |
54541 |
| Job Title: |
Sr. Corporate Communications Specialist |
| Dept: |
Public Affairs |
| Part/Full Time: |
Full Time |
| Work Hours: |
8:30 a.m. - 4:45 p.m. |
| Standard Hours: |
37.5 |
| Location: |
Pittsburgh |
| Date Posted: |
6/10/2008 12:00:00 AM |
| Duties: |
Responsible for the achievement of public relations goals, planning and implementing all aspects of GHP's communications policies, as well as for the development of both national-level and local-level media and community relations initiatives. Develops and distributes internal communications regarding GHP initiatives and programs. Writes and edits materials, including web content, to support the communications needs of senior management, the businesses and functional areas as assigned. Works with ad agencies and related consultants to develop and/or implement corporate communication messaging and materials. Manages GHP grants and donations to community organizations and agencies. |
| Qualifications: |
REQUIRED: High school diploma or GED and seven (7) years of professional experience in Public Relations. OR Associates degree and five (5) years of professional experience in Public Relations.
PREFERRED: Bachelor's degree in communications-related field (journalism, communications, English or marketing). Acquired senior-level writing and editing skills, including ability to consistently produce quality results in a deadline-driven environment; Business acumen and political sensitivity. Experience with executive communications, corporate initiatives and/or web communications. Must be able to perform in a fast-paced, changing, multi-project environment.
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| Job ID: |
54505 |
| Job Title: |
Governmental Affairs Specialist |
| Dept: |
Regulatory, Compliance & Legal Affairs |
| Part/Full Time: |
Full Time |
| Work Hours: |
8:30 a.m. - 4:45 p.m. |
| Standard Hours: |
37.5 |
| Location: |
Pittsburgh |
| Date Posted: |
5/30/2008 12:00:00 AM |
| Duties: |
Primarily responsible for managing the relationships between Gateway Health Plan and the Department of Public Welfare (DPW) and the Department of Health (DOH). Function as the primary contacts with DPW for regulatory issues. The conduct and performance of the Governmental Affairs Specialists reflect on the Health Plan directly, and the rapport established between the Specialists and their DPW contacts impacts both the day-to-day operations and overall relationship with the Plan's regulators. Responsible for interpreting, confirming and clarifying regulations governing HMO practices in order to attain organizational compliance with regulations. Analyze contractual provisions with DPW and educate Gateway staff regarding required and prohibited activities. Prepare report and response submissions to governmental agencies and edit information by individual contributors. Must act as a liaison who professionally represents Gateway's business interests on a wide variety of issues in order to accomplish the mission and goals set forth by Gateway's management.
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| Qualifications: |
REQUIRED: High School diploma or GED. Three (3) years experience with the compliance or regulatory process in healthcare or a healthcare-related field. One (1) year experience with PC.
PREFERRED: Bachelor's degree in or equivalent training in healthcare or related field. Certification in or equivalent training in the Academy for Healthcare Management self-study course. Three (3) to five (5) years of experience is preferred in HMO operations, preferably Medicaid HMO operations.
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| Job ID: |
54297 |
| Job Title: |
Pharmacy Clerk |
| Dept: |
Pharmacy |
| Part/Full Time: |
Full Time |
| Work Hours: |
8:30 a.m. - 4:45 p.m. |
| Standard Hours: |
37.5 |
| Location: |
Pittsburgh |
| Date Posted: |
5/13/2008 12:00:00 AM |
| Duties: |
Responsible for providing all clerical support necessary to assure the delivery of timely, efficient and effective clinical services provided by the Pharmacy Department. Responsible for the daily generation of denial/approval letters and mailings and pharmacy data input into Onbase database consistent with regulatory standards/requirements as defined by DPW and all other regulatory agencies.
Demonstrate on a consistent basis the individual and team behaviors that embody GHP's service excellence philosophy. Perform other activities as defined by the Director and/or Manager in support of the mission of the department.
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| Qualifications: |
REQUIRED: High school diploma or GED.
PREFERRED: Associate's degree in or equivalent training in Computers, IS, data summary. One (1) to three (3) years of experience in computer skills including Word, Excel, Outlook.
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| Job ID: |
54187 |
| Job Title: |
Operational Compliance Specialist |
| Dept: |
Regulatory, Compliance & Legal |
| Part/Full Time: |
Full Time |
| Work Hours: |
8:30 a.m. - 4:45 p.m. |
| Standard Hours: |
37.5 |
| Location: |
Pittsburgh |
| Date Posted: |
4/30/2008 12:00:00 AM |
| Duties: |
Performs internal audits and compliance reviews to assure compliance of related processes with respect to regulatory agency requirements and corporate policies and procedures. Audits may include operational audits, quality improvement audits, as well as internal regulatory and accreditation mock audits. Identifies, defines, suggests and implements, with oversight from department management, resolution for complex business issues that may be department specific or cross-departmental. Maintains, develops and updates policies and procedures related to area to support accreditation and ongoing compliance. Partners with and supports internal regulatory staff and external regulatory representatives on related issues and questions. Serves as a department point of contact for specific delegated entities; monitors delegated entity for compliance with regulatory requirements and provides reporting and corrective action plans. Prepares contract language pertaining to service level agreements and/or specifications of delegated activities, in conjunction with business owners or department management, and the legal department. Assures contract language complies with requirements specified by governing regulatory agencies.
Supports integration of new lines of business; assures processes and procedures are being followed and/or identifies areas of risk for new lines of business; develops training materials and serves as a resource for training and questions.
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| Qualifications: |
REQUIRED: High School Diploma or GED. Three years of experience with compliance or regulatory processes. Demonstrated understanding of implications of non-compliance with regulations, bulletins, manuals, contracts, standards, etc. Two years experience with quality measurement systems. One year experience evaluating, implementing or revising work processes.
PREFERRED: Bachelor's degree; Quality Management System certification. One (1) year experience in performing auditing / monitoring functions. One (1) year experience creating tools, training documents and educational materials geared to adult learners. Two (2) years experience with Microsoft Office Products (i.e. Word, Excel, PowerPoint). Two (2) years experience working in health care / health insurance industry.
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| Job ID: |
54042 |
| Job Title: |
Application Developer II |
| Dept: |
Information Systems |
| Part/Full Time: |
Full Time |
| Work Hours: |
8:30 a.m. - 4:45 p.m. |
| Standard Hours: |
37.5 |
| Location: |
Pittsburgh |
| Date Posted: |
4/22/2008 12:00:00 AM |
| Duties: |
Providing technical expertise/ support: Within an assigned systems unit/area, usually as a member of a project team or production support team, in the design and development of small and medium business applications. On projects or systems issues of a moderate to complex nature.
Develop relationships and integrate activities with other systems departments to ensure successful implementation and support of project efforts. Collect and analyze business and system requirements for small and medium projects. Identify conflicting system integration issues of a moderate to complex nature and recommend alternative solutions. Develop and maintain good relationships with customers and systems colleagues to meet expected customer service levels. Define application scope and objectives of a moderate to complex nature. Assist in the enhancements of procedures to solve business problems.
Prepare detailed specifications of a moderate to complex nature to develop programs to include: design, code, test, debug and document programs. Provide input on the status of project efforts, anticipating/identifying issues that inhibit the attainment of project goals and implementing corrective actions. Assist and/or prepare application development project plans. Provide assistance:
In the analysis, design, programming, testing and implementation for new and existing business application software and/ or provide Production support of small and medium business applications. In the support of the technical systems environment; this may include performance monitoring, issue resolution and specific product support. In the support and compliance of all Gateway Health Plan corporate policies and procedures.
This position will comply with all Gateway Health Plan policies, procedures and standards.
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| Qualifications: |
REQUIRED QUALIFICATIONS: High School Diploma or GED and one (1) year experience: Utilizing software development lifecycle. Interfacing with business partners and/or customers. Two (2) years experience: Developing and supporting business applications. Utilizing application programming language and programming tools. Utilizing database modeling. PREFERRED QUALIFICATIONS: Bachelor's Degree; High School Diploma or GED plus three (3) years experience: Utilizing software development lifecycle. Interfacing with business partners and/or customers. High School Diploma or GED plus three (3) years experience: In developing and supporting business applications. Utilizing applicable application programming language. Utilizing database modeling and programming tools. Program design experience. Healthcare industry experience.
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| Job ID: |
54032 |
| Job Title: |
Project Manager |
| Dept: |
Project Management |
| Part/Full Time: |
Full Time |
| Work Hours: |
8:30 a.m. - 4:45 p.m. |
| Standard Hours: |
37.5 |
| Location: |
Pittsburgh |
| Date Posted: |
4/17/2008 12:00:00 AM |
| Duties: |
Lead, facilitate and oversee the development and execution of projects and strategic initiatives that support the Corporate Strategic Plan. Managing multiple cross-functional projects as directed by the Project Management Office Director. Lead and/or facilitate cross departmental team meetings, maintain Gantt charts, coordinate related project activities, assist with process mapping and project planning from design through implementation and evaluation.
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| Qualifications: |
REQUIRED: Bachelors degree. Five (5) years experience in project management in a healthcare-related field.
PREFERRED: Academy for Healthcare Management courses. Project Management Professional (PMP). Academy for Healthcare Management Fellowship.
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| Job ID: |
53922 |
| Job Title: |
Medical Case Manager |
| Dept: |
Special Needs-Case management |
| Part/Full Time: |
Full Time |
| Work Hours: |
8:30 a.m. - 4:45 p.m. |
| Standard Hours: |
37.5 |
| Location: |
Pittsburgh |
| Date Posted: |
4/30/2008 12:00:00 AM |
| Duties: |
Assure that members with complex medical and/or psychosocial needs have access to high quality, cost-effective health care. Assist in the holistic assessment, planning, arranging, coordinating, monitoring, evaluation of outcomes and activities necessary to facilitate member access to healthcare services. Advocate for the most appropriate care plan using sound clinical judgment; accurate planning, and collaboration with internal and/or external customers and contacts. Follow established regulatory guidelines, policies, and procedures in relation to member interventions and documentation of activities related to the member's care and progress across the continuum of care. Facilitation and/or participation in interdisciplinary and/or interagency meetings when necessary to facilitate coordination of services/resources for members.
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| Qualifications: |
REQUIRED: Bachelor's degree in nursing or RN certification or Master's degree in Social Work and three years experience in Acute or Managed Care/ experience with Medicaid or Medicare populations. OR Bachelor's degree in Social Work with five years experience in Acute or Managed Care/ experience with Medicaid or Medicare populations.
PREFERRED: Case Management Certification. Professionally Licensed Social Worker or Nurse. Three to five years of experience in working in Acute Care/Managed Care/Medicaid and Medicare populations. Bilingual English/Spanish language skills.
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| Job ID: |
53781 |
| Job Title: |
Accounting Associate |
| Dept: |
Finance |
| Part/Full Time: |
Full Time |
| Work Hours: |
8:30 a.m. - 4:45 p.m. |
| Standard Hours: |
37.5 |
| Location: |
Pittsburgh |
| Date Posted: |
3/31/2008 12:00:00 AM |
| Duties: |
Assist in the processing of trade Accounts Payable including preparation of invoices for payment, data entry, assignment of general ledger coding, balance to control totals and printing and distribution of checks. Assist in preparation of Health Care Provider Claims vendor refunds and inquiries using DST claims system. Also, assist in day-to-day collection of vendor/provider overpayments. Assist in maintenance of trade A/P systems including resolution of vendor and internal staff inquiries, filing, preparation of 1099 tax information and preparation of annual external audit materials. Assist in maintenance of Accounts Payable Claims system including scanning, indexing and filing. Other duties as assigned.
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| Qualifications: |
Required: High school diploma/GED and two (2) years experience in accounting, finance or claims-related processing.
Preferred: Associate's degree in accounting or business.
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| Job ID: |
53398 |
| Job Title: |
Help Desk Specialist 2 |
| Dept: |
Information Systems |
| Part/Full Time: |
Full Time |
| Work Hours: |
8:30 a.m. - 4:45 p.m. |
| Standard Hours: |
37.5 |
| Location: |
Pittsburgh |
| Date Posted: |
3/14/2008 12:00:00 AM |
| Duties: |
Provide technical, administrative and informational assistance for desktop operating systems, applications software and hardware, other network peripherals (optical scanners, printers, etc.) and telephone services. Provide second-tier support for all reported desktop issues and/or problems. Work with vendors and third-party providers for the implementation and support of new technology. Maintain corporate hardware and software inventories. Develop and maintain corporate and departmental policies and procedures. Deploy new desktop hardware and software and coordinate the repair and/or replacement of malfunctioning hardware. Relocation of staff including telephone services. |
| Qualifications: |
Required:
High school diploma or GED. Three (3) years experience with desktop operating systems, hardware and software.
Preferred:
BS in Computer Science or Information Systems. MSCE.
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| Job ID: |
53329 |
| Job Title: |
Outreach Representative |
| Dept: |
Preventive Health/Disease Management |
| Part/Full Time: |
Full Time |
| Work Hours: |
8:30 a.m. - 4:45 p.m. |
| Standard Hours: |
37.5 |
| Location: |
Pittsburgh |
| Date Posted: |
3/11/2008 12:00:00 AM |
| Duties: |
Responsible for telephonic outreach efforts related to members. Work closely with members, providers and other community agencies to proactively coordinate access to preventive health services. Conducts community and provider training on EPSDT services. Assists in the development of member and provider education materials related to EPSDT services. Collaborates with various human service providers in the identification and outreach to members in need of EPSDT services. Conducts telephonic outreach to enroll appropriate members in specialized chronic disease programs. Conducts telephonic assessments with members. Work collaboratively with internal departments at GHP including, but not limited to, utilization management and case management.
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| Qualifications: |
Required:
HS Diploma OR GED. One (1) year experience in Community Outreach/Customer Service.
Preferred:
Undergraduate degree in a business field. One (1) year experience with the Medical Assistance population and/or managed care. Strong organizational skills along with excellent written and verbal communication skills. Strong active listening skills with the ability to act sensitively toward diverse people and situations. Ability to successfully interact with external customers, peers, colleagues and management team. Demonstrated effective time management skills and an ability to prioritize and handle multiple tasks simultaneously. Ability to function in a team environment. Experience with software programs such as Word, Excel and Outlook. Ability to coordinate special projects. The ability to speak in front of groups. Bilingual, Spanish speaking.
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| Job ID: |
53328 |
| Job Title: |
Outreach Representative |
| Dept: |
Preventive Health/Disease Management |
| Part/Full Time: |
Full Time |
| Work Hours: |
8:30 a.m. - 4:45 p.m. |
| Standard Hours: |
37.5 |
| Location: |
Pittsburgh |
| Date Posted: |
3/11/2008 12:00:00 AM |
| Duties: |
Responsible for telephonic outreach efforts related to members. Works closely with members, providers and other community agencies to proactively coordinate access to preventive health services. Conduct community and provider training on EPSDT services. Assist in the development of member and provider education materials related to EPSDT services. Collaborate with various human service providers in the identification and outreach to members in need of EPSDT services. Conduct telephonic outreach to enroll appropriate members in specialized chronic disease programs. Conduct telephonic assessments with members. Work collaboratively with internal departments at GHP including, but not limited to, utilization management and case management.
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| Qualifications: |
Required:
HS diploma OR GED. One (1) year experience in Community Outreach/Customer Service.
Preferred:
Undergraduate degree in a business field. One (1) year experience with the Medical Assistance population and/or managed care. Strong organizational skills along with excellent written and verbal communication skills. Strong active listening skills with the ability to act sensitively toward diverse people and situations. Ability to successfully interact with external customers, peers, colleagues and management team. Demonstrated effective time management skills and an ability to prioritize and handle multiple tasks simultaneously. Ability to function in a team environment. Experience with software programs such as Word, Excel and Outlook. Ability to coordinate special projects. The ability to speak in front of groups. Bilingual, Spanish speaking.
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| Job ID: |
53327 |
| Job Title: |
Medical Case Manager |
| Dept: |
Special Needs-Case Management |
| Part/Full Time: |
Full Time |
| Work Hours: |
8:30 a.m. - 4:45 p.m. |
| Standard Hours: |
37.5 |
| Location: |
Pittsburgh |
| Date Posted: |
3/10/2008 12:00:00 AM |
| Duties: |
Assure that members with complex medical and/or psychosocial needs have access to high quality, cost-effective healthcare. Assist in the holistic assessment, planning, arranging, coordinating, monitoring, evaluation of outcomes and activities necessary to facilitate member access to healthcare services. Advocate for the most appropriate care plan using sound clinical judgment; accurate planning and collaboration with internal and/or external customers and contacts. Follow established regulatory guidelines, policies, and procedures in relation to member interventions and documentation of activities related to the member's care and progress across the continuum of care. Facilitation and/or participation in interdisciplinary and/or interagency meetings when necessary to facilitate coordination of services/resources for members.
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| Qualifications: |
Required:
Bachelor's degree in nursing or RN certification or Master's degree in Social Work and three years experience in acute or managed care/ experience with Medicaid or Medicare populations OR Bachelor's degree in Social Work with five years experience in acute or managed care/ experience with Medicaid or Medicare populations.
Preferred:
Case Management Certification. Professionally Licensed Social Worker or Nurse. Three to five years of experience in working in acute care/managed care/Medicaid and Medicare populations. Bilingual English/Spanish language skills.
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| Job ID: |
53324 |
| Job Title: |
Network Support Analyst |
| Dept: |
Information Services |
| Part/Full Time: |
Full Time |
| Work Hours: |
8:30 a.m. - 4:45 p.m. |
| Standard Hours: |
37.5 |
| Location: |
Pittsburgh |
| Date Posted: |
3/7/2008 12:00:00 AM |
| Duties: |
Establish guidelines to develop and maintain all servers (database servers, application servers, email servers, storage servers and other network appliances), systems, applications, security and network configuration. Recommend upgrades and new technology acquisition based on a constant review of current technology trends and understanding of the business needs and objectives. Create and implement project plans for system upgrades, reconfigurations and new system installations. Troubleshoot and resolve server and network issues. Create and test Disaster Recovery/Business Continuity strategies and plans. Provide oversight and guidance to other technical staff for resolution of issues. Participate in the development of the annual IS capital and expense budgets. Work with Security Engineer to design and implement solutions to ensure security of the Gateway network, servers, telecommuting and email systems.
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| Qualifications: |
Required: Bachelor's degree in Computer Science or Information Science. Five (5) years experience in a network support position.
Preferred:
MCSE certification, CCNA certification.
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| Job ID: |
53101 |
| Job Title: |
Manager, QI |
| Dept: |
Quality Improvement |
| Part/Full Time: |
Full Time |
| Work Hours: |
8:30 a.m. - 4:45 p.m. |
| Standard Hours: |
37.5 |
| Location: |
Pittsburgh |
| Date Posted: |
3/24/2008 12:00:00 AM |
| Duties: |
With oversight from Director responsible for strategic planning, development, implementation and monitoring of the quality portion of the Quality Improvement/Utilization Management Program and Work Plan and Pay for Performance Programs. Initiate within all Gateway Health PlanSM Departments, collaborative activities based on sound data analysis to promote the development, implementation, monitoring and evaluation of quality related programs and services. Assure the standards of the National Committee for Quality Assurance (NCQA) and all applicable State and Federal Regulatory Agencies are appropriately integrated into the Quality Improvement/Utilization Management Program. With oversight from the Director, accountable for the program management and ongoing implementation of DPW's MCO Pay for Performance Program, the Gateway Provider Pay for Performance Program and other assigned Quality Improvement initiatives. Build and execute the business plans (strategic and operational) for various programs and initiatives; gain approval and assure ongoing program and initiative implementation to support the achievement of goals and objectives. Analyze the effectiveness of the business plan and make recommendations for program changes. Manage QI staff and resources. Assign staff to support cross-departmental project teams. Assure project teams are operating effectively and are completing work within required timeframes. Conduct performance reviews and ongoing staff development. Develop and manage department budget.
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| Qualifications: |
Required: RN. Four (4) years of experience in Quality Improvement/Management. Two (2) years previous supervisory or team lead experience. Four (4) years leadership experience in NCQA survey preparation. Nurse applicants, a Pennsylvania RN License or eligible for Pennsylvania RN Licensure by Endorsement.
Preferred: Four (4) years combined experience in Quality Improvement, Utilization Management, Disease Management, Preventive Health or Case Management in a managed care health plan environment. Four (4) years managed care health plan experience in Medicaid / Medicare. Understanding of healthcare diseases or conditions, their management, healthcare delivery systems and processes. Certification in Quality Management Principles.
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| Job ID: |
53034 |
| Job Title: |
Disease Management Specialist |
| Dept: |
Preventive Health/Disease Management |
| Part/Full Time: |
Full Time |
| Work Hours: |
8:30 a.m. - 4:45 p.m. |
| Standard Hours: |
37.5 |
| Location: |
Pittsburgh |
| Date Posted: |
2/11/2008 12:00:00 AM |
| Duties: |
Develop, implement and oversee multi-disciplinary disease management programs. Work closely with the Chief Medical Officer, Medical Directors, the Director and Manager to assure that operational goals are monitored, internal and external trainings take place, opportunities for ongoing program enhancements are identified, collaboration and integration with other departments occurs, reporting for internal and external review is completed in a timely fashion, coordination with external vendors and partners is achieved and documentation of program progress is maintained. Lead, coordinate and perform as primary expert source of information Outreach and Nurse Care managers to optimize positive health outcomes for members enrolled in Disease Management Programs. Assure that all clinical and operational challenges are identified, that the problem is solved appropriately by setting protocol and procedures for specific member cases assigned to Nurse Care Managers. Play a lead role in the development of Prospective Care Management at Gateway Health Plan.
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| Qualifications: |
REQUIRED QUALIFICATIONS:
Bachelor's degree in Nursing or an RN Certification. Three (3) years of work experience in a clinical setting.
One (1) year of work experience in a healthcare setting. One (1) year combined experience Word, PowerPoint, project management, word processing and spreadsheet experience.
Licenses:
Registered Nurse. Current PA license.
PREFERRED QUALIFICATIONS:
Must have excellent communication skills, public speaking and creative writing experience. Must have strong problem solving skills, organizational skills and time management skills with the ability to work in a fast-paced environment and change priorities as required. Must be able to take a proactive and holistic approach to assessment and intervention. Must be able to successfully interact with external customers, peers, colleagues and management team. Must be able to examine best practices, evaluate data, trends, provider opinions and member awareness for the purpose of trouble shooting and problem solving. Must demonstrate effective time management skills and demonstrate an ability to prioritize and handle multiple tasks simultaneously. Must be able to function in a team environment. Certified Case Manager preferred.
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| Job ID: |
52880 |
| Job Title: |
Medicare Marketing Rep. - Central/Eastern PA |
| Dept: |
Medicare Marketing & Sales |
| Part/Full Time: |
Full-Time |
| Work Hours: |
8:30 a.m. - 4:45 p.m. |
| Standard Hours: |
37.5 |
| Location: |
Telecommuting - Central/Eastern PA |
| Date Posted: |
1/25/2008 12:00:00 AM |
| Duties: |
Prospect, promote and sell Gateway Health Plan's Medicare Assured product in the Central/Eastern PA region. Consistently meet or exceed monthly sales goals within assigned territory. Support overall department sales goals. Develop and implement sales plan for assigned territory. Identify and network with community partners, identify easy access/high traffic locations for meetings, schedule and meet with potential members at various sites, which may include home visits. Provide marketing and promotional materials and presentations. Qualify prospective members and assure applications are in compliance with CMS (Center for Medicare and Medicaid Services) regulations and company policies and procedures. Assure accurate completion and timely submission of leads, enrollments, expense reports and work calendars and related information for the marketing database. Collaborate with inside sales representatives and other departments within the company to identify marketing opportunities and to capitalize on internal strength and relationships.
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| Qualifications: |
REQUIRED QUALIFICATIONS: High school diploma or GED. Four years of progressive experience in sales. Valid PA driver's license or the ability to travel to various worksites. Must have Pennsylvania and Ohio insurance agent license or acquire licenses within sixty (60) days of hire.
OTHER/ PREFERRED QUALIFICATIONS: BS/BA Degree. Consultative selling experience. Bilingual (English & Spanish). Experience in Medicare, Medicaid and/or HMO environment. Proficiency with MS Office applications (Outlook, Word, Excel and PowerPoint). |
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| Job ID: |
52878 |
| Job Title: |
Administrative Assistant |
| Dept: |
Medicare Marketing Department |
| Part/Full Time: |
Full Time |
| Work Hours: |
8:30 a.m. - 4:45 p.m. |
| Standard Hours: |
37.5 |
| Location: |
Pittsburgh |
| Date Posted: |
3/31/2008 12:00:00 AM |
| Duties: |
Perform routine secretarial and general office duties for the Medicare Marketing Department. Assure timely and accurate completion of all assignments to enhance the efficiency and effectiveness of the principal in meeting operational objectives. Responsibilities include typing, word processing, proofreading, handling phone calls, maintaining and organizing files, copying, reviewing and distributing mail, greeting visitors, ordering supplies, scheduling calendars and making travel arrangements. Organize and expedite work flow.
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| Qualifications: |
Required: High school education/GED and a minimum of one (1) year of secretarial or administrative experience.
Preferred: Excellent typing, word processing and proofreading skills as well as a working knowledge of PC word processing, spreadsheet and graphic applications including MS Office, Powerpoint, Excel, Word and Outlook.
The incumbent should possess the utmost integrity in the discreet handling of confidential information.
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| Job ID: |
52803 |
| Job Title: |
Medicare Marketing Rep - Johnstown & Surrounding Counties |
| Dept: |
Medicare Marketing & Sales |
| Part/Full Time: |
Full-Time |
| Work Hours: |
8:30 a.m. - 4:45 p.m. |
| Standard Hours: |
37.5 |
| Location: |
Telecommuting - Johnstown & Surrounding Counties |
| Date Posted: |
1/25/2008 12:00:00 AM |
| Duties: |
Prospect, promote and sell Gateway Health Plan's Medicare Assured product in the Johnstown, PA and surrounding counties. Consistently meet or exceed monthly sales goals within assigned territory. Support overall department sales goals. Develop and implement sales plan for assigned territory. Identify and network with community partners, identify easy access/high traffic locations for meetings, schedule and meet with potential members at various sites, which may include home visits. Provide marketing and promotional materials and presentations. Qualify prospective members and assure applications are in compliance with CMS (Center for Medicare and Medicaid Services) regulations and company policies and procedures. Assure accurate completion and timely submission of leads, enrollments, expense reports and work calendars and related information for the marketing database. Collaborate with inside sales representatives and other departments within the company to identify marketing opportunities and to capitalize on internal strength and relationships. |
| Qualifications: |
REQUIRED QUALIFICATIONS: High school diploma or GED. Four years of progressive experience in sales. Valid PA driver's license or the ability to travel to various worksites. Must have Pennsylvania and Ohio insurance agent license or acquire licenses within sixty (60) days of hire.
OTHER/ PREFERRED QUALIFICATIONS: BS/BA Degree. Consultative selling experience. Bilingual (English & Spanish). Experience in Medicare, Medicaid and/or HMO environment. Proficiency with MS Office applications (Outlook, Word, Excel and PowerPoint). |
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