- Cigna (Newton, MA)
- …strong external relationships with provider partners. Intimate understanding and experience with hospital , managed care , and provider business models. Team ... in lieu of a bachelor's degree. MBA or MHA preferred. 3+ years Managed Care contracting and negotiating experience involving complex delivery systems and… more
- Fort Duncan Regional Medical Center (Eagle Pass, TX)
- …in acute care , utilization review, case management. Strong working knowledge of hospital billing, managed care systems, and discharge planning. Excellent ... collaborative healthcare setting. About Fort Duncan Regional Medical Center Acute care hospital with 101 private rooms, advanced imaging (CT, MRI, ultrasound,… more
- Pyramid Consulting, Inc. (Austin, TX)
- …degree or advanced degree (Pharm.D., MS) in pharmacy. 2+ years of mail order, retail, hospital or managed care pharmacy experience or 1+ years of pharmacy ... residency program experience. Licenses/Certifications: Current state's Pharmacist license with no restrictions. Our client is a leading Healthcare Industry and we are currently interviewing to fill this and other similar contract positions. If you are… more
- Saviance (Boston, MA)
- …audits. 17. Stay abreast of all government regulations and procedures affecting hospital / managed care /corporate finance and accounting procedures. 18. ... Enhance professional growth and development through educational programs, seminars, workshops, and conferences. 19. Perform other related duties as required. EDUCATION: Bachelor's Degree (or equivalent) required, preferably in Finance or Accounting.… more
- Tal Healthcare (White Plains, NY)
- …medical center in Westchester County, is seeking a detail-oriented and analytical Managed Care Analyst to support its growing revenue cycle operations. ... decisions. Cross-Functional Collaboration Serve as a liaison between revenue cycle, managed care , finance, and payer representatives. Participate in Joint… more
- PIH Health (Whittier, CA)
- …to payers Required Experience Required: High School Diploma Minimum two years in hospital Medi-Cal and Medi-Cal Manage Care billing and follow up Knowledge ... responsible for the timely and accurate billing through resolution of Medi-Cal/ Managed MediCal inpatient and outpatient accounts. This includes billing, collection… more
- Gaylord Specialty Healthcare (Wallingford, CT)
- … companies in a timely manner. Prevents denials through pro-active intervention with managed care reviewers, physicians and hospital staff. Administers ... education and support to hospital staff regarding community resources, managed care issues, or payment / payer issues. *Demonstrates an ability to be… more
- Teva Pharmaceuticals (Parsippany, NJ)
- …and new people to make a difference with. The opportunity The Associate Director, Managed Care Payer Analytics is responsible for leading the analytical strategy ... SQL, and data visualization tools (eg, Tableau, Power BI). Experience with managed markets data sources such as customer portal, claims, rebate submissions and… more
- UnitedHealth Group (Brooklyn, NY)
- …CRC certification Nursing background ie LPN, RN, NP 4+ years of clinic or hospital experience and/or managed care experience 1+ years of coding ... Optum is a global organization that delivers care , aided by technology to help millions of...directly improve health outcomes by connecting people with the care , pharmacy benefits, data and resources they need to… more
- UnitedHealth Group (Fort Worth, TX)
- …Preferred Qualifications: 5+ years of experience in a physician's office, clinical or hospital setting Knowledge of managed care , referral processes, claims ... employment 2+ years of experience in a physician's office, clinical or hospital setting Cardiac, medical-surgical and/or critical care experience Experience… more
- Texas Children's Hospital (Houston, TX)
- … setting experience in community health, complex pediatric patient care , home care , case management, managed care , or utilization review highly preferred ... Work for ten consecutive years. Texas Children's comprehensive health care network includes our primary hospital in...comprehensive health care network includes our primary hospital in the Texas Medical Center with expertise in… more
- Mount Sinai Hospital (Greenlawn, NY)
- …insurance information utilizing internal or electronic sources. Obtains and documents managed care referrals, required pre-certifications and authorizations as ... insurance information utilizing internal or electronic sources. Obtains and documents managed care referrals, required pre-certifications and authorizations as… more
- Mount Sinai Hospital (New York, NY)
- …and contract compliance activities with the goal of optimizing and improving managed care reimbursement through efficient clinical delivery and aligned clinical ... practices economical and effective healthcare Completes in a timely manner all managed care applications, credentialing, and re-credentialing requests from the… more
- Mount Sinai Hospital (New York, NY)
- …of the hospital staff and extended community *Communicates effectively with managed care , insurance companies, EAP's, and other current or potential referral ... including at least bi-weekly appointment with each patient on caseload *Interfaces with managed care companies and referral sources to implement Treatment Plans… more
- Thomas Jefferson University Hospitals, Inc. (Philadelphia, PA)
- … care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage ... Job Details RN Hospital Per Diem Job Description Awards & Recognition... is recognized for their high performance in specialty care such as Diabetes & Endocrinology, Cancer, Cardiology, Heart… more
- St. John's Riverside Hospital (Yonkers, NY)
- …in all necessary activities to ensure payment for treatment services by insurance/ managed care companies including, but not limited to, Medicaid/Medicare. ... most with a strong emphasis on patient and family-focused nursing care . St. John's Riverside Hospital staff is committed to making life better for all patients.… more
- Mount Sinai Hospital (New York, NY)
- …regarding policies and procedures, billing related training, contractual relationships with managed care organizations, capital procurement and space allocation. ... are resolved. Coordinates planning and implementation of contractual relationships with managed care organization. Reviews and evaluates manual and computerized… more
- Thomas Jefferson University Hospitals, Inc. (Philadelphia, PA)
- Job Details The advanced practice provider (Nurse Practitioner/Physician Assistant) within the acute care hospital setting works in collaboration with, and is an ... locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options… more
- San Dimas Community Hospital (San Dimas, CA)
- …Knowledge in discharge planning/utilization management/case management terminology and functions, in both managed care and non- managed care environments. ... Overview San Dimas Community Hospital is a 101 bed facility located on...are committed to serving the community with personalized, high-quality care . We offer a full range of comprehensive services,… more
- Trinity Health (Farmington, MI)
- …working within a hospital or clinic environment, a health insurance company, managed care organization or other health care financial service setting, ... in a timely and accurate manner. Communicates with appropriate hospital departments to clarify billing discrepancies, and obtain demographic, clinical,… more
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