- buyer (New York, NY)
- …preferred. 5-8 years of experience in managed care operations, health care administration or quality improvement with direct oversight and leadership ... list of products, including, but not limited to, New York State Medicaid Managed Care , Medicare, Child Health Plus, Exchange, Partnership in Care… more
- Plante Moran (Denver, CO)
- …are met and high- quality support is consistently provided. Collaborate with internal Managed IT team members and our clients to design and implement customized ... Count on us. Our "we- care " culture is more than just a motto; it's a...managed service solutions that meet clients' goals and expectations. Conduct regular… more
- buyer (New York, NY)
- …list of products, including, but not limited to, New York State Medicaid Managed Care , Medicare, Child Health Plus, Exchange, Partnership in Care ... demonstrated knowledge in researching, reviewing and interpreting laws and regulations.3-5 years of Medicaid Managed Care or Managed Care Special Needs… more
- Clever Care Health Plan (Huntington Beach, CA)
- …and staff. Collects and compiles the required documentation to maintain critical quality improvement functions. Telephonic and electronic outreach to patients ... to CAHPS and HEDIS/Risk gaps. Conducts member outreach for quality initiatives including HEDIS or wellness care ...or minimum two (2) years' experience in health plan, managed care or equivalent experience. Knowledge of… more
- Lucile Packard Children's Hospital (Palo Alto, CA)
- …others. * Ability to solve problems and identify solutions. * Knowledge of managed care environment and patient service delivery systems and knowledge of ... flow and analyzes needs for the practice to assure quality patient care . * Partners with the...communication, standard work (ie staffing and space), continuous process improvement , and resource deployment and to assure practice needs… more
- Sprenger Wellspring Silver Maple (Lorain, OH)
- …Ascertains knowledge of patient pay source and make visits appropriately. Ensures managed care patients have authorizations prior to visits. Submits schedules ... Licensed Practical Nurse. Participates in agency activities which promote quality patient care and/or are part of...care and/or are part of the agencys Performance Improvement (PI) program. Quarterly Clinical Record Review Performance … more
- DATAPATH INC (Duluth, GA)
- …All of our solutions are backed by industry leading management tools, customer care and field support. At DataPath we are passionate about developing easy-to-use ... top- quality products that help our clients achieve their mission...providing recommendations for future technical solutions and areas for improvement With collaboration oversee implementation and maintenance of resilient… more
- The Career Sphere (Escanaba, MI)
- …equipment and nurse staffing budgets. Maintain current knowledge of applicable managed care , Medicare and state Medicaid regulations, reimbursement systems ... and perform resident rounds to monitor and evaluate the quality and appropriateness of nursing care . Ensure...and methodology. Participate in the Quality Assurance Performance Improvement … more
- Knox Community Hospital (Mount Vernon, OH)
- …for information as requested and necessary for the Patient Center Medical Home, Managed Care Organizations, BWC, attorneys, and employers; copy, fax, and/or ... as assigned and approved by completion of annual competencies. Promotes continuous quality improvement /customer service efforts. Enhance the services provided to… more
- Aya MSP / MedStar Union Memorial Hospital (Baltimore, MD)
- …anesthesiologists, and other healthcare professionals, to ensure safe, effective, and high- quality care for patients undergoing cardiovascular surgeries. Key ... and equipment are properly maintained and stocked. Participate in continuous quality improvement initiatives, ensuring compliance with surgical protocols, safety… 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
- PEAK Technical Staffing USA (Minneapolis, MN)
- …sites to inspect and test components before shipping to assembly Drive continuous improvement by finding ways to enhance quality and performance with shop ... experience with BS degree or 5+ years' experience with MS degree (Principal) Managed risks associated with custom designs Worked with clients' input to innovate and… more
- HCA Healthcare (Campbell, CA)
- …with purpose and integrity. We care like family! Jump-start your career as a Managed Care Quality Improvement Specialist today with HCA Healthcare. ... **_Note: Eligibility for benefits may vary by location._** Come join our team as a Managed Care Quality Improvement Specialist. We care for our… more
- Molina Healthcare (Syracuse, NY)
- …improving provider quality performance through provider engagement, practice transformation, managed care quality improvement , or equivalent ... value-based care , and capitation * Strong working knowledge of quality metrics and risk adjustment practices across all business lines * Demonstrates… more
- Molina Healthcare (New York, NY)
- …improving provider Quality performance through provider engagement, practice transformation, managed care quality improvement , or equivalent ... Care contracts have engagement plans to meet annual quality and risk adjustment goals. Drives coaching and collaboration...care , and capitation * Strong working knowledge of Quality metrics and risk adjustment practices across all business… more
- Molina Healthcare (Longview, TX)
- …improving provider Quality performance through provider engagement, practice transformation, managed care quality improvement , or equivalent ... role implements Health Plan provider engagement strategy to achieve positive quality and risk adjustment outcomes through effective provider engagement activities.… more
- Hackensack Meridian Health (Edison, NJ)
- …employees. + Knowledge of managed care principles. + Knowledge of Quality Improvement Program - New Jersey program and its Quality Metrics. ... as a leader of positive change. The **Transitions of Care Navigator** is a member of the healthcare team...and is responsible for coordinating, communicating and facilitating the care of patients with Medical, Behavioral and Maternal Health… more
- Banner Health (Phoenix, AZ)
- …implementing continuous improvement initiatives. + Experience with hospital medical staff, managed care organizations, and quality improvement ... Ensure adherence to policies, procedures, and regulatory requirements while driving continuous improvement in patient care and safety. + Manage budgets,… more
- Option Care Health (Nashville, TN)
- …negotiations, preparation, financial analysis, business review, and implementation of assigned Managed Care clients, 340B, and Health System Partnership ... home and alternate site infusion services provided by Option Care . . Responsible for managed care...infusion therapy. With more than 2,900 clinical experts, Option Care Health is able to provide high- quality … more
- McLaren Health Care (Flint, MI)
- …+ Five (5) years' experience performing quality management activities in a managed care organization, including HEDIS, NCQA, including at least two (2) ... policies and procedures that support all aspects of the Quality Improvement Performance Plan (QPIP). Manages the...Information Set (HEDIS) process. Facilitates the delivery of medical care in a cost efficient and quality … more
