- Molina Healthcare (San Antonio, TX)
- …in health care field including, but not limited to, provider's office, managed care , or other health care field. **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS ... with large specialty or multispecialty provider groups. * 1-3 Years Managed Care experience **PREFERRED EXPERIENCE** : Knowledge of integrated delivery… more
- Molina Healthcare (Miami, FL)
- …in health care field including, but not limited to, provider's office, managed care , or other health care field. **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS ... **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy...large specialty or multispecialty provider groups. * 1-3 Years Managed Care experience **PREFERRED EXPERIENCE** : Provider… more
- Oracle (San Antonio, TX)
- …+ Proficient in Microsoft Office suite. **Responsibilities** The Customer Deal Desk Specialist III leads and manages the contracting process end-to-end for ... This is not a remote role.** **Customer Deal Desk Specialist III** An ideal candidate has a strong work... III sets the overall direction for his/her assigned managed deal(s) and is responsible for the successful execution… more
- HCA Healthcare (Campbell, CA)
- …of health plan economics analyses, metrics and health plan reporting in a Managed Care environment relating to the financial, quality and operational performance ... Come join our team as a Health Plan Economics Specialist . We care for our community! Just...for Health plan Metrics, Analytics and Reporting for a Managed Care organization + Develop and maintain… more
- BayCare Health System (FL)
- …resolves errors and issues by coordinating with the plans/payors, the CBO and the Managed Care contracting department. + This includes ensuring the ... and processes provider applications for renewals reappointments. + Enrolls and maintains managed care enrollment for providers by providing updates to the… more
- Stony Brook University (East Setauket, NY)
- …and denied accounts. + Collaborates on denials prevention initiatives. + Liaises with Managed Care Contracting and Insurance Company Provider Representatives ... Senior Revenue Cycle Specialist **Position Summary:** At Stony Brook Medicine, the...Hospital Revenue Cycle or Patient Accounting Department resolving hospital Managed Care payment variances and/or denials. **Job… more
- Houston Methodist (Sugar Land, TX)
- …+ Maintains knowledge of Federal, State, and local billing regulations and partners with managed care contracting as needed. + Maintains knowledge of ... determinations and, denial reason and trending as appropriate, Monitors CMS, managed care and payor communications for updates/alerts/releases and functions… more
- Vistra (Irving, TX)
- …and Salary will be dependent upon education and experience The Procurement Specialist is responsible for driving savings and implementing contractual protections for ... the company. Tasks include leading sourcing events as well as facilitating the contracting and procurement processes. A solid knowledge of all aspects of the… more
- CareFirst (Baltimore, MD)
- …management experience on the payer side using MCG criteria. Working knowledge of managed care and health delivery systems. + Thorough knowledge of CareFirst ... Utilizing key principles of utilization management, the Utilization Review Specialist will perform prospective, concurrent and retrospective reviews for… more
- CareFirst (Baltimore, MD)
- …years experience in risk adjustment coding, ambulatory coding and/or CRC coding experience in managed care ; state or federal health care programs; or health ... submissions. Utilizes coding expertise, combined with medical policy, credentialing, and contracting rules knowledge to build the effective guides and resources for… more
- Amgen (Washington, DC)
- …and memberships), contracts, strategies, and rebates and fee transactions for payer ( managed care ), channel, and provider rebates. + Works cross-functionally ... Join us and transform the lives of patients while transforming your career. ** Specialist IS Business Systems Analyst - Product Team** **What you will do** Let's… more
- Waystar (Atlanta, GA)
- …Develop and maintain strong relationships with payers, including health insurance companies, managed care organizations, and government agencies. + Create new, ... **ABOUT THIS POSITION** The Payer Relations Specialist is responsible for initiatives to identify and...performance. + Track and communicate the status of payer contracting and connections activities **OPTIONAL DETAILS --Looking for… more
- Penn Medicine (Plainsboro, NJ)
- …significant knowledge of all types in-network and out-of-network health insurance, managed care companies, benefits and policies for commercial, Medicare ... regulations and requirements + Ability to develop a good working relationship with managed care organizations, and provide excellent customer service + Ability… more
- AmeriHealth Caritas (Philadelphia, PA)
- … care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral ... Your career starts now. We're looking for the next generation of health care leaders. At AmeriHealth Caritas, we're passionate about helping people get care ,… more
- AmeriHealth Caritas (Miami, FL)
- …contract management, or contract administration in a healthcare or Managed Care organization. + Experience with contracting software (eg, Portico, McKesson, ... to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and...more about us at www.amerihealthcaritas.com **Role Overview:** The Contract Specialist connects our team, the health plan, and key… more
- Molina Healthcare (Rockford, IL)
- …will have the following experience-** + Live in Illinois and are familiar with Managed Care in Illinois and how HHF operates. + Background/experience in business ... Molina Healthcare is hiring a Sr Specialist in our Government Contracts department. This role...field. **Required Experience** + 3 years' experience in a managed care environment. + Experience demonstrates strong:… more
- Veterans Affairs, Veterans Health Administration (Huntington, WV)
- Summary The Mobility Transportation Specialist functions as a subject matter expert in all matters of beneficiary travel and modes of veteran transport for the ... transportation to Veterans who require assistance traveling to and from VA health care facilities and authorized non-VA health care appointments within the… more
- Carnival Cruise Line (Miami, FL)
- …Effectively coordinate and collaborate with stakeholders to ensure ownership and contracting is deliberately/consciously managed and applied. + Measuring and ... something for everyone. We are looking for an amazing Specialist , Training Governance to fill this role, which is...targets are met and that corporate reporting requirements are managed . + Responsible for all governance group preparation and… more
- Veterans Affairs, Veterans Health Administration (San Diego, CA)
- Summary This position serves as an Inventory Management Specialist (EX) in the Supply Chain Management Service at the Veteran Affairs Health Care System San ... matter expert to all services and service lines. Inventories managed include a wide variety of expendable items and...materially affect the VA HCS' ability to provide medical care to Veterans. Researches opportunities for and conducts analysis… more
- Nuvance Health (Danbury, CT)
- …on a daily/regular basis with the Denials Management team. * Assists with informing Managed Care contracting team with necessary contractual language to ... * Current working knowledge of utilization management, performance improvement and managed care reimbursement. Working Conditions: Manual: Some manual… more