- Novo Nordisk Inc. (Traverse City, MI)
- … in order to influence formulary status, as applicable May analyze impact of managed care in the territory and its effect on prescribing decisions, and ... Novo Nordisk, we are the world leader in diabetes care and a major player in defeating other serious...partners. Internally, the DCS report to the District Business Manager of the specific sales territory. The DCS also… more
- MCI Careers (Wichita, KS)
- …industry. We are seeking a highly skilled and motivated Call Center Customer Service Manager to lead a team of supervisors and drive performance across our customer ... of 5-10 supervisors within a complex call center environment. The Operations Manager position is responsible for ensuring call quality from start to finish,… more
- Molina Healthcare (Long Beach, CA)
- …limited to, provider's office, managed care organization, or other health care environment. *3+ years experience in provider contract negotiations in a ... Tighter knit proximity ongoing after contract . *In conjunction with Director/ Manager , Provider Contracts , negotiates Complex Provider contracts including… more
- Molina Healthcare (Long Beach, CA)
- …in health care field including, but not limited to, provider's office, managed care , or other health care field. REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS ... in contracting with large specialty or multispecialty provider groups. *1-3 Years Managed Care experience PREFERRED EXPERIENCE : Knowledge of integrated delivery… more
- Pediatrix (Houston, TX)
- …clinical providers and service locations. Partner with CMD, Director of Operations (DO)/Service Area Manager (SAM) and Managed Care team for effective market ... Overview Responsibilities The Practice Manager will effectively interface with the practice and...review of unique payer arrangements and affiliated contracts . Coordinate and assist all corporate departments to support… more
- AmeriHealth Caritas Health Plan (Detroit, MI)
- … health care requirements 3 to 5 years in a managed care -related or healthcare industry Proven experience with contract management tools (ie, we use ... Contract Manager , Emptpros) Proficiency in researching regulatory requirements and managed care industry best practices Skills & Abilities Database… more
- COPE Health Solutions (Riverside, CA)
- Description The ECM Care Manager - Licensed Vocational Nurse... care with the ECM healthcare team and managed care plan. Under the clinical direction ... and oversight of the Primary Care Physician and Registered Nurse, the LVN coordinates ...job description nor any other communication creates an employment contract between the Company and the employee. Qualifications: Current… more
- Blue Cross and Blue Shield of Minnesota (St. Paul, MN)
- …Certification 5 years of RN or relevant clinical experience. 1+ years of managed care experience (eg case management, utilization management and/or auditing ... nursing. Certification in utilization management or a related field. Experience in UM/CM/QA/ Managed Care . Knowledge of state and/or federal regulatory policies… more
- Cigna (Newton, MA)
- …in lieu of a bachelor's degree. MBA or MHA preferred. 3+ years Managed Care contracting and negotiating experience involving complex delivery systems and ... external relationships with provider partners. Intimate understanding and experience with hospital, managed care , and provider business models. Team player with… more
- Penn State Health (Hershey, PA)
- …population as determined by individualized plan of care , clinical pathways, managed care guidelines and contracts . Mobilizes resources and manages ... and the ability to provide individualized, innovative, and specialized care to patients in the community. Penn State Health...on the terms outlined in company policy or union contract . All individuals (including current employees) selected for a… more
- Sigma, Inc. (Pittsburgh, PA)
- …Preferred Skills: Certified Case Manager (CCM) credential. Previous experience in Managed Care or Health Plans . Familiarity with preventive services , ... Job Title: Remote RN Case Manager - Contract (9464-1) | Pittsburgh,...in improving health outcomes for vulnerable populations through patient-centered care and telephonic engagement. ? Due to the governmental… more
- St. John's Riverside Hospital (Yonkers, NY)
- …insurance contracts . 4. Responsible for maintaining and forwarding all managed care authorization, re-certification and denials to clinicians and clinical ... means to be Community Strong Responsibilities The Senior Office Manager - Outpatient Services BHS oversees and manages all...Review and reconcile remittance files for Medicaid FFS, Medicaid Managed Care , Medicare B, and Commercial payers.… more
- Odyssey (Pittsburgh, PA)
- See yourself at Odyssey. Join the team as our new Sales Manager . Who We Are & Why We're Hiring: Join Odyssey Logistics - A Global Leader in Multimodal Logistics At ... key divisions: Intermodal, Freight Forwarding, Transport & Warehousing, and Managed Services. By integrating advanced analytics, strong carrier relationships,… more
- Lakeland Care, Inc. (Green Bay, WI)
- …our award winning culture as we serve members in your area! Position Summary: The RN Care Manager (RN CM), as part of an interdisciplinary team (IDT) with a ... Care Manager , serves Lakeland Care 's (LCI)...want to live in. With long-standing roots as a managed care organization (MCO), we provide long-term … more
- PacificSource (Boise, ID)
- …experience in lieu of degree. Master's degree preferred. Knowledge: Experience with managed care /provider contract stewardship inclusive of contract ... include managed dental care entity (or Dental Care Organization/DCO) contracts , performance, and relationship stewardship. This role acts… more
- Artech LLC (Portland, OR)
- …of federal and state regulations, laws and accreditation standards related to health care and managed care organizations. Knowledge of member complaint ... verbal and written communication skills. Ability to work with peers in self- managed teams. Ability to prioritize work and ensure all compliance elements are… more
- DocGo (New York, NY)
- …Ambulnz medical transport services, DocGo is bridging the gap between physical and virtual care . Job Overview: As a Sales Manager at Cardiac RMS by DocGo, ... Title: Sales Manager - Cardiac Device Remote Monitoring Employment Type...is leading the proactive healthcare revolution with an innovative care delivery platform that includes mobile health services, population… more
- Northwestern Memorial Healthcare (Lake Forest, IL)
- …Monitors avoidable days and recommends change in services or processes. Ensures compliance with managed care contracts and length of stay targets while ... forgiveness to 401(k) matching and lifecycle benefits, we take care of our employees. Ready to join our quest...week located at Lake Forest Hospital. ** The Case Manager /Social Worker reflects the mission, vision, and values of… more
- Lakeland Care, Inc. (Green Bay, WI)
- …culture as we support members in your area! Position Summary: The part-time Registered Nurse Care Manager (RN CM) Float acts as a temporary member of the ... care management in partnership with a part-time Care Manager (CM) Float to LCI members....want to live in. With long-standing roots as a managed care organization (MCO), we provide long-term… more
- County of Los Angeles, CA (Los Angeles, CA)
- …Health is seeking qualified candidates to fill emergency Mental Health Program Manager II vacancies related to the homelessness crisis. Under the emergency order, ... assessment will be considered for permanent appointment to Mental Health Program Manager II. Essential Job Functions Performs the full range of administrative… more
