- Blue Shield of California (San Diego, CA)
- …review for members seeking mental health and/or substance use disorder treatment. The Operations Specialist , Experienced will report to the Sr. Manager, BH UM. ... relevant experience Understanding of behavioral health facility-based levels of care preferred Experience with Prior Authorization preferred Experience working with… more
- Sevita (Minneapolis, MN)
- …forms Strong understanding of medical collections compliance, Medicare, Medicaid, Medicaid managed care , Commercial, Workers Comp, and Auto-no-fault payer types ... Accounts Receivable Collections Specialist Do you have experience in Accounts Receivable/Collections and a desire to work for a company that positively impacts the… more
- Macpower Digital Assets Edge (Los Angeles, CA)
- …equivalent education and/or experience may be considered. minimum of 3-5 years of Managed Care , Medicaid, Medicare experience required. minimum of 3-5 experience ... of training programs. Must have 3 years experience in Healthcare Industry. Managed Care experience. ppeals & Grievances experience-preferably as Lead. 3… more
- WinnCompanies (Baltimore, MD)
- WinnCompanies is looking for an Occupancy Specialist II to join our team at Chase Hous e , a 189-unit affordable housing community located in Baltimore, MD. In this ... are run and delivered timely. Ensure all prospect information is maintained and managed in a waitlist and in compliance with regulations, including but not limited… more
- BG Consulting Services LLC (Bethesda, MD)
- …referral record accordingly. 6. Determine appointment needs according to local and regional managed care rules. Validates and implements MTF policy in support of ... to the patient. 25. Research and analyze complex health care operations . Prepare presentations, project papers, staff...health care delivery systems, military management health care principles and techniques, TRICARE Managed Health… more
- Shepherd Center (Atlanta, GA)
- …rehabilitation center, or as an external case manager. Knowledge of Commercial, Managed Care Contracts and Governmental Insurance Plans. Experience in automated ... of staff members working at Shepherd for more than 20 years. The Operations Access Specialist performs administrative services for an assigned program/location.… more
- Raytheon Technologies (Mckinney, TX)
- …for a security clearance Security Clearance: DoD Clearance: Secret Raytheon Company, Managed by Collins Aerospace Joining Collins Aerospace isn't just about finding ... to redefine the future of aerospace technology. We are currently seeking a Principal Specialist , Program Cost Control s to join our team. This position is an… more
- Cook Children's Health Care System (Fort Worth, TX)
- …billing, insurance follow-up, or healthcare business office experience Understanding of Managed Care contracts, denials and payor methodology Effective oral ... Location: Calmont Operations Building Department: CBO/Patient Financial Services Shift: First...leadership of Patient Financial Services (PFS) management, the Account Specialist is responsible for accounts receivable through claim follow… more
- Prisma Health (Columbia, SC)
- …primary care chart is up to date with scheduling information about specialist consults, tests, and procedures managed . Alerts management to trends in ... a seamless entry in to the Prisma Health experience. The Referral Specialist interfaces with patients and physician office team members to accurately authorize… more
- Texas Tech University (Lubbock, TX)
- …workplace community with a positive culture that puts people first. Since 1989, TTUHSC Managed Care has served as a healthcare delivery service, providing high ... position is responsible for ensuring the smooth flow of operations in a correctional facility medical clinic. Employees serve...services to patients in 22 facilities throughout West Texas. Managed Care emphasizes our values-based culture in… more
- Northern Light Health (Bangor, ME)
- …conflict, collaborating with others, and applying self-reflection to their practice. The specialist is responsible for the delivery of care , facilitating change ... Variable Work Schedule: 7:00 AM to 3:30 PM Summary: Inpatient Admissions Specialist consists of two distinct nursing roles divided between coordination of internal… more
- Essen Medical Associates (Bronx, NY)
- …by outside agencies, including the OCR, CMS, CMS contractors, the OIG and managed care insurance agencies. Prepares appeals of adverse decisions resulting from ... Overview At Essen Health Care , we care for that! As...appropriate. Monitors legal and regulatory developments relating to Essen operations and advises applicable departments of same. Maintains current… more
- APLA Health (Los Angeles, CA)
- …to healthcare (eg interpreter services, transportation). Work with the transitions of care specialist to coordinate ED/ER follow up patient appointments. Work ... with emergency management and preparedness plans and tasks. Assist with grant-funded and managed care organization facility and medical record audits. Promote a… more
- Texas Children's Hospital (Bellaire, TX)
- …and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area. To join our ... with our company. In this position you will assist in overseeing the daily operations of the ADM, reports, audits and database management. Think you've got what it… more
- Southern Veterinary Partners (Commerce City, CO)
- …small animal veterinary hospital providing comprehensive medical, surgical and dental care . Veterinary Center at Turnberry is a family owned business started ... and the use of external laboratories. We also work closely with local specialist practices when referral diagnostic procedures are required. The facility includes a… more
- Stony Brook University (Commack, NY)
- Managed Care Provider Enrollment Specialist **Position Summary** At Stony Brook Medicine, as a Managed Care Provider Enrollment Specialist , you ... Meeting House Lane Medical Practice, PC._ **Duties of a Managed Care Provider Enrollment Specialist ...to report to work to protect, recover, and continue operations at Stony Brook Medicine, Stony Brook University Hospital… more
- MSC Industrial Supply Co. (Albuquerque, NM)
- …are a leading North American distributor of metalworking and maintenance, repair, and operations (MRO), products and services. We offer more than 2 million products ... hours per day.- - BRIEF POSITION SUMMARY: The _Vendor Managed Inventory (VMI) Specialist_ ensures customer satisfaction through solutions...MSC customer solutions and sales associates through execution of CARE program. + CARE is defined as… more
- MSC Industrial Supply Co. (Eau Claire, WI)
- …are a leading North American distributor of metalworking and maintenance, repair, and operations (MRO), products and services. We offer more than 2 million products ... Eau Claire or Chippewa Falls-** **BRIEF POSITION SUMMARY:** The **_Vendor Managed Inventory (VMI) Specialist_** ensures customer satisfaction through solutions by… more
- New York State Civil Service (Schenectady, NY)
- NY HELP Yes Agency People With Developmental Disabilities, Office for Title Program Operations Specialist 1 / Trainee - Upstate Occupational Category Other ... LinkedIn: https://www.linkedin.com/company/nys-office-for-people-with-developmental-disabilities/posts/?feedView=all #LI-JT1 Minimum Qualifications NON-COMPETITIVE MINIMUM QUALIFICATIONS: Program Operations Specialist 1: A bachelor's degree in… more
- Huron Consulting Group (Van Buren, AR)
- …and drive physician, patient and employee engagement across the enterprise. The Huron Managed Services Coding Operations Director oversees a portfolio of clients ... Resource Management, Culture, Staff Engagement, Training and Solution Development. The Huron Managed Services Coding Operations Director leads the operations … more
