Jobs at Magellan Health

Manages provider and facility networks for small to mid-size markets. Responsibilities include assessing network adequacy, recruiting and contracting providers, resolving provider issues, conducting education and site visits, maintaining credentialing status, auditing compliance, addressing quality concerns, and recommending policy updates. Requires knowledge of NCQA requirements, strong organizational and presentation skills, Microsoft Office proficiency, and at least one year of related experience.

Owns the vision, strategy, roadmap, feature definition, release planning, and performance measurement for IT clinical solution products. Partners with business and technical stakeholders on build-versus-buy decisions, architecture, licensing, change management, KPIs, ROI, migration, risk mitigation, and product adoption. Coordinates cross-functional delivery and vendor relationships while adapting product direction to changing business needs.

Provides customer service and administrative support for the U.S. Navy’s DEERS/RAPIDS identification card program. Verifies identities and eligibility, issues CACs and military identification cards, updates DEERS records, performs PIN resets and PKI certificate updates, answers customer inquiries, and maintains RAPIDS workstations and card materials. The role requires customer service experience, military or comparable HR knowledge, Microsoft Office proficiency, U.S. citizenship, and a favorably adjudicated Tier 3 investigation.

Supervises and ensures the quality of clinical care for adolescents receiving ASACS services. Mentors counselors, guides high-risk case decisions, reviews PCOMS data and clinical records, verifies treatment documentation and referral logs, and ensures compliance with ASACS procedures. The supervisor conducts peer and record reviews, evaluates case-management processes, and prepares quarterly summaries of findings.

Provides customer service and administrative support for the U.S. Navy’s Identification Card Administration program. Verifies beneficiary identity and eligibility, issues DoD identification and CAC cards, updates DEERS records, performs PIN resets and PKI certificate updates, and maintains RAPIDS workstations. The specialist answers eligibility and application questions, reconciles erroneous information, safeguards card materials, and performs equipment user maintenance. Requires a high school diploma, customer service experience, relevant HR or equivalent experience, communication skills, Microsoft Office proficiency, U.S. citizenship, and a Tier 3 NACLC investigation.

Leads federal business development strategy and pipeline management from opportunity identification through qualification, capture, and proposal support. Develops account strategies, assesses client and competitive dynamics, presents gate reviews, and contributes to teaming, pricing, and solution development. Builds relationships with federal stakeholders, industry partners, and internal teams while supporting revenue growth targets. Guides junior business development staff and ensures compliance with business development processes and tools.

Leads Magellan Health’s enterprise data and analytics strategy, modernization, engineering, governance, business intelligence, and AI/ML enablement. Oversees data platforms, pipelines, quality, lineage, compliance, and reporting while partnering with clinical, operational, and financial stakeholders. Builds and develops a 30+ person organization, manages a $3M–$5M budget, oversees vendors, and presents investment cases to executive leadership. Drives transformation from a low-maturity environment to a governed, insight-driven enterprise data platform.

Manages reporting and analytics operations, teams, workflows, critical business intelligence reports, and performance metrics. Leads data process improvements, requirements analysis, systems development, testing, reporting projects, and process re-engineering. Uses SQL, data warehouses, QlikView, Tableau, and related tools to support operational, financial, quality, compliance, and strategic decisions. Mentors staff, manages priorities, monitors risks, and partners with business leaders and clients.

Supervise and manage Personal Financial Counselors (PFCs), ensure DoD program compliance, review deliverables, oversee counseling quality, coordinate with installation POCs, handle conflict of interest and reporting processes, and support quality improvement and program reporting.

Provide ID/CAC customer service at Navy DEERS/RAPIDS sites: verify identity and eligibility, issue DoD ID cards, perform DEERS enrollments/updates, maintain RAPIDS equipment, process CACs, reset PINs, update PKI, and respond to customer inquiries per DoD regulations.

Serve as trusted advisor overseeing implementation and adoption of technology solutions. Manage client relationships, stakeholder communication, issue tracking, status reporting, and cross-functional coordination to ensure successful delivery and client value realization.