- Beth Israel Lahey Health (Westwood, MA)
- … care or specialty physicians, their patients and practices to coordinate and process managed care referrals and / or authorizations for patient care ... services, complying with BIDCO's and BIDMC's contractual rules for multiple managed care insurance payers. **Job Description:** **Essential Responsibilities:**… more
- Fallon Health (Norwood, MA)
- …or follow us on Facebook, Twitter and LinkedIn. **Brief summary of purpose:** The BH Care Coordinator serves as a bridge between the community and the health ... partner locations **Responsibilities** **The role of the Behavioral Health Care Coordinator is to:** + maintain a...and motivational interviewing required + Experience in a healthcare managed care company, nursing facility, or in… more
- Humana (Providence, RI)
- …+ Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization + Proficient utilizing electronic medical record ... caring community and help us put health first** The UM Administration Coordinator contributes to administration of utilization management. The UM Administration … more
- Fallon Health (Worcester, MA)
- …experience in related position, preferably in health care . + Experience in a managed care or call center setting or physician's office; knowledge of ... applicable regulatory requirements, and customer expectations. The FH Authorization Coordinator serves to administer the FH prior authorization process...managed care and/or utilization management strategies advisable… more
- Fallon Health (Worcester, MA)
- …a company that cares. We prioritize our members-always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon ... Health delivers equitable, high-quality, coordinated care and is continually rated among the nation's top...focus toward excellent customer service. In addition, the Service Coordinator will attain the targets for a customer service… more
- Beth Israel Lahey Health (Needham, MA)
- …period- the office is located in Stoughton, MA. The Clinician Onboarding Coordinator provides professional support to the (BILHPC South) Clinician Onboarding Manager ... issues with insurance plans. Implements enrollment for health plans not managed by BILHPN. Supports onboarding process for all providers. **Job Description:**… more
- US Tech Solutions (Canton, MA)
- …experience with Microsoft Office products and HR systems + Preferred: Knowledge of the managed care / health care industry **Skill requirements:** + Attention ... closely with outsourced leave administration vendor to ensure all leaves are managed appropriately. Escalate issues and resolve problems. + Provide and implement… more
- Cardinal Health (Providence, RI)
- …Minimum 2 years of experience in Insurance follow-up preferred + Understanding of managed care contracts and fee schedules, including Medicare and Medicaid ... accurately, efficiently, promptly, recognizing their importance and relationship to patient care + Consults with appeals department for disputed / denied claims.… more
- Edward M. Kennedy Community Health Center, Inc. (Worcester, MA)
- …that the health center accepts. Additionally, assist with changing insurance primary care provider and assist with enrollment into health plan. + Follow proper ... + Enter all necessary information into EPM and scan all necessary forms. Managed paper flow (encounter forms, labels) necessary for patients to receive appropriate… more
- Highmark Health (Providence, RI)
- …degree + Pharmacy technician certification certificate + Experience working in a managed care medication formulary management environment + Working knowledge of ... retail pharmacy and/or third party prescription procession + Strong background and understanding of medications and formulary terminology + Pharmacy technicians must be familiar with multiple Medicaid drug benefit design offerings and rules/regulations across… more
- CenterWell (Providence, RI)
- …for off-days during the week.** + **Required to work every other holiday.** The **Clinical Care Coordinator ** helps to ensure optimal continuity of care for ... Home Health services including home health, hospice, and palliative care . The Clinical Care Coordinator ...management, discharge planning and patient education for adult acute care + Managed care experience… more
- Fallon Health (Worcester, MA)
- …criteria, explaining processes for member request determinations and helping members navigate the managed care system + ** Care Team Communication** + Follows ... access to reliable transportation **Experience:** + 2+ years job experience in a managed care company, medical related field, or community social service agency… more
- Athena Health Care Systems (East Providence, RI)
- …Activities Assistant, you assist the Director of Therapeutic Recreation and/or Memory Care Program Coordinator in planning, organizing, developing, and directing ... of personal characteristics, are encouraged to apply. Athena Health Care Systems and its managed centers follow...apply. Athena Health Care Systems and its managed centers follow federal and state mandatory guidelines regarding… more
- Athena Health Care Systems (Providence, RI)
- …Activities Assistant, you assist the Director of Therapeutic Recreation and/or Memory Care Program Coordinator in planning, organizing, developing, and directing ... individuals, regardless of personal characteristics, are encouraged to apply. Athena Health Care Systems and its managed facilities/agencies follow federal and… more