Careers

Below is a list of functions you can search when seeking a position at CCP.

Claims

After physicians’ and other providers’ services are completed on behalf of our enrollees, our Claims Department processes their requests for payment.

Compliance

The CCP Compliance department is responsible for ensuring that CCP, the CCP Board of Directors, management and employees are in compliance with all government statutes, rules and regulations. Under the auspices of the Compliance Department, our CCP Special Investigations Unit is responsible for detecting, investigating, and reporting instances of fraud, waste, and abuse committed by Medicaid enrollees, providers and facilities.

Finance

Our Finance team is responsible for planning, organizing, auditing, and accounting for our finances as well as producing our financial statements.

Government Programs

Our Government Programs team works directly with our contracted state agencies to ensure our company meets all contractual requirements in order to provide the highest quality of care to our enrollees.

Human Resources

Our employees are the heart of Community Care Plan. The Human Resources department strives to meet the needs and address the concerns of our staff and provide them with the training, tools and education to perform their jobs with passion, commitment and dedication, as well as reach their professional goals.

Information Technology

Our IT department supports CCP’s organizational goals by developing, implementing and maintaining computer hardware and software systems that organize and communicate information electronically. Their responsibilities range from keeping systems and data secure to keeping networks up and running.

Medical Management

Credentialing To assure our enrollees receive high quality health care services, our Credentialing team verifies the qualifications, background and education of providers who request membership in our physician network.

Pharmacy The CCP Pharmacy Department oversees and administers prescription drug benefits and Medication Therapy Management services for our Medicaid enrollees and all commercial lines of business. Our Pharmacy staff oversee quality, utilization, and cost management of pharmaceuticals through formulary maintenance and oversight, accurate claims processing, oversight of prior authorizations, pharmacy spend, and generic utilization, with the goal of quality, cost-effective pharmaceuticals for all enrollees.

Population Health Our Population Health department is comprised of clinical staff (RN’s, LPN’s and Social Workers) as well as administrative support staff who work with enrollees to help them manage their medical conditions and encourage them to practice preventive self-care.

Quality And Clinical Performance Improvement Our Quality Management RN team focuses on health plan performance measures, as well as review of potential quality of care issues and adverse events, provider education regarding Child Health Check Up and HEDIS measures, health studies, and accreditation.

Utilization Management When our enrollees need treatments, procedures, tests, and advanced medical care, CCP’s utilization management department, a staff of medical professionals and support staff, review requests that require prior authorization by the health plan.

Member Services

At the heart of our customer service program, the Member Services staff takes calls and handles requests from our enrollees. The staff consists of Member Services representatives and associates, all focused on providing outstanding concierge service.

Provider Operations

Our Provider Operations team understands the importance of developing and maintaining strong relationships with our network providers. They work with our providers to eliminate challenges and provide excellent quality healthcare for our enrollees. Provider Operations contracts and maintains our provider network in accordance with quality and contractual guidelines.