- Daiichi Sankyo, Inc. (Bernards, NJ)
- …creation and supply of innovative pharmaceutical therapies to improve standards of care and address diversified, unmet medical needs of people globally by leveraging ... is primarily responsible for monitoring / auditing HCP (Health Care Provider) activities for all engagements pertaining to their...to DSI Planners for correction, with a copy to manager and department head.Provide timeline to address issues and… more
- PhysEmp (Gardena, CA)
- …works with these patients utilizing rules set forth by the VA for co- managed care .Conducts individual, group, and family and marriage counseling and/or ... all clinical reminders 'due' at the time of each patient visit.Assists in co- managed care collaboration with non-VA providers, and facilities.Functions as case … more
- MaineGeneral Rehabilitation and Long Term Care - Gray Birch (Augusta, ME)
- …week and holiday rotations - Shifts are from 6:45 PM to 7:15 AM, with scheduling managed by the team manager Additional Information: - Dress Code: Lime Green and ... Details Client Name MaineGeneral Rehabilitation and Long Term Care - Gray Birch Job Type Travel Offering...Gold Seal of Approval for Healthcare Staffing Services Certification Contract & local rates may vary based on location… more
- HealthCare Support (Houston, TX)
- …prior to processing authorization requests. Accurately enters the required information into the managed care platform, adhering to UM policies and procedures. 5. ... clinical information to authorize medically necessary inpatient and outpatient care , utilizing nationally recognized evidenced based clinical criteria or approved… more
- Baystate Health (Springfield, MA)
- Summary Description: The Sr. Managed Care Contract Manager will act as the catalyst between the contract , contract parties and the data. ... Managed Care Contract Team at Baycare Health Partners. The Sr. Managed Care Contract Manager , will also perform research and collect data to… more
- AdventHealth (Maitland, FL)
- …adjudication. Provides guidance and direction to PFS, Central Denials, Patient Access and Managed Care staff regarding contract terms and policies including; ... for the Florida division. This position assists the Sr. Contract Manager with ensuring that preferred ...contract data elements which are populated into the Managed Care database including addition of new… more
- Option Care Health (Nashville, TN)
- …Education and Experience Requirements** High school diploma and 10yrs of experience in managed care account management or contract analysis and negotiation ... care services. Experience in working with managed care clients and familiarity with contract terms and conditions in the ancillary arena. Experience with… more
- Henry Ford Health System (Troy, MI)
- …EDUCATION/EXPERIENCE REQUIRED: + Bachelor's degree in Finance, Accounting, Business Administration, Managed Care Contracting, Reimbursement, or related field. + ... GENERAL SUMMARY: Under minimal supervision of the Manager , independently leads financial and data analysis to...to seven (5-7) years of experience in healthcare finance, managed care contracting, or reimbursement in a… more
- AdventHealth (Maitland, FL)
- …partners, vendors and leadership after identifying and quantifying the issue. Supports the Managed Care Contract Administration, AH Central Denials team, and ... non-contracted products. Provides expert guidance to Regional Directors and Managed Care staff in reference to technical...issues or trends. Pivots detail for distribution to assigned Contract Manager or analyst. Contributes to the… more
- Molina Healthcare (Cleveland, OH)
- …integrity and other cost recovery processes + Direct PM experience in Managed Care Operations (claims, system configuration, provider data management preferred) ... and appreciates the member environments we serve + Exposure to all Managed Care industry functional departments **JOB QUALIFICATIONS** **Required Education** +… more
- Elevance Health (KS)
- ** Managed Care Coordinator** Location: Seeking candidates to work in Sedgwick, Cowley, Butler, or Reno County, Kansas. **_Please note that per our policy on ... responsiveness to client needs, and direct, hands-on engagement. The ** Managed Care Coordinator** is responsible for overall...of position, as required by applicable state law and contract . **How you will make an impact:** + Responsible… more
- Hartford HealthCare (Hartford, CT)
- …**Organization:** **Hartford HealthCare Corp.* **Title:** *Sr Payer Analyst / Managed Care Contracting* **Location:** *Connecticut-Hartford-100 Pearl Street ... across the system. *_Position Summary:_* Reporting directly to the Manager of Payer Contract Analytics, the Sr....Minimum: BA/BS degree . Preferred: BA/BS degree in Health Care , MIS, Finance, Statistics or Mathematics *Experience* . Minimum:… more
- Elevance Health (Bryson City, NC)
- **CFSP Managed Care Coordinator** **Sign-on Bonus: $2500** **We are currently seeking people in the following counties and look forward to speaking with you!** ... thrive in safe, stable, and nurturing homes._ The **CFSP Managed Care Coordinator** is responsible for the...CFSP Program, as required by applicable state law and contract . **How you will make an impact:** + Provide… more
- Atrius Health (Newton, MA)
- …welfare benefit package. **Job:** **Accounting/Billing/Finance* **Organization:** **Finance* **Title:** *Senior Managed Care Analyst* **Location:** *Newton MA - ... Atrius Health, an innovative healthcare leader, delivers an effective system of connected care for more than 690,000 adult and pediatric patients at 30 medical… more
- Elevance Health (Roanoke, VA)
- …for employment, unless an accommodation is granted as required by law. The ** Managed Care Coordinator - Southwest Virginia** is responsible for performing ... and pre-defined identification process, identifies members with potential clinical health care needs (including, but not limited to, potential for high-risk… more
- InGenesis (Columbia, SC)
- InGenesis is currently seeking a Registered Nurse / RN - Managed Care Coordinator to work for our client located in Columbia, SC. In this role you will review ... * Identify and makes referrals to appropriate staff (Medical Director, Case Manager , Preventive Services, Subrogation, Quality of care Referrals, etc.). *… more
- AdventHealth (Maitland, FL)
- …department leadership within Patient Financial Services (PFS), Physician Practice leadership and Managed Care staff regarding contract interpretation and the ... Enterprise leaders to keep them informed of any concerns related to managed care reimbursement and operational contract issues. Ensures key stakeholders are… more
- CommonSpirit Health (Phoenix, AZ)
- …+ Knowledge and experience in reimbursement, the financial aspects of contracting and managed care operations + Contract language + Effective project ... **Job Summary and Responsibilities** **Job Summary:** The Division Contract Manager for Payer Strategy &...compliance on a regional and market level; ensuring that managed care contracts are correctly negotiated and… more
- Mount Sinai Health System (New York, NY)
- …Agreements and Amendments, financial performance for all contracts, and facility, ancillary related contract negotiations. The Managed Care Team is at the ... work at the forefront of innovation in healthcare The Managed Care Contracting Team within MSHP is...the Mount Sinai Health System. MSHP seeks a **Senior Contract Manager Analyst** will play a critical… more
- Henry Ford Health System (Detroit, MI)
- GENERAL SUMMARY: Under minimal supervision, the Network Contract Manager oversees the tracking and management of value-based contracts within the Clinically ... effective communication and cooperation. Routinely collaborates with corporate departments including Managed Care Contracting/ Revenue Cycle. . Collaborates with… more
