- PharmaCord (Lexington, KY)
- …team immediately at ###@pharmacord.com When you join the team as an Executive Case Manager , you'll have the opportunity to make a difference in the lives of our ... prescriptions or cases are handled in a timely manner. An Executive Case Manager has the ability to translate knowledge into patient friendly language and education.… more
- Valvoline Global (Lexington, KY)
- …we'll lead the way. **We are originality in motion.** Our corporate values- ** Care , Integrity, Passion, Unity, and Excellence** -are at the heart of everything we ... united in our commitment to: - Treating everyone with care . - Acting with unwavering integrity. - Striving for...procurement and logistics initiatives, reporting directly to the Procurement Manager . You will play a critical role in sourcing,… more
- Cardinal Health (Frankfort, KY)
- ** Manager , Managed Care ** **What Managed Care contributes to Cardinal Health** Practice Operations Management oversees the business and ... administrative operations of a medical practice. Managed Care oversees the interactions that take place between payer and provider(s) to ensure optimal… more
- Molina Healthcare (Lexington, KY)
- …QUALIFICATIONS:** + At least 6 years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health plan setting, ... integrity issues, and process gaps. + Applies understanding of healthcare regulations, managed care claims workflows, and provider reimbursement models to shape… more
- Molina Healthcare (Lexington, KY)
- …years of experience in a pharmacy, Medication Therapy Management (MTM), Pharmacy Benefit Manager (PBM), and/or managed care setting, or equivalent combination ... Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care . **Essential Job… more
- Molina Healthcare (Lexington, KY)
- …* At least 8 years clinical systems experience, preferably as a product owner / manager within a managed care , nursing informatics or health care ... implementation, and oversight of technology that drives core utilization management, care management, long-term services and supports (LTSS), clinical operations and… more
- Molina Healthcare (Lexington, KY)
- …Nursing preferred. **Required Experience** 1-3 years in case management, disease management, managed care or medical or behavioral health settings. **Required ... in Nursing **Preferred Experience** 3-5 years in case management, disease management, managed care or medical or behavioral health settings. Preferred License,… more
- Option Care Health (Lexington, KY)
- …Option Care . Description of available services is accurate. Meets with managed care organizations and other accounts to facilitate education regarding ... no limit to the growth of your career.** Option Care Health, Inc. is the largest independent home and...brightest talent in healthcare. **Job Description Summary:** The Pharmacy Manager is a licensed professional who is responsible for… more
- CenterWell (Frankfort, KY)
- …Nurse with a Bachelor of Science in Nursing (BSN) to join our team as a Care Manager , Telephonic Nurse 2. In this pivotal role, you will play a crucial ... infectious diseases, cancer(s), and other rare ailments. As a Care Manager , Telephonic Nurse your primary responsibility...Microsoft Office applications including Word, Excel, and Outlook + Managed care experience + Must be passionate… more
- CVS Health (Frankfort, KY)
- …model preferred. + Discharge Planning Experience. + Motivational Interviewing skills + Managed Care /Utilization Review Experience + Bilingual preferred. + BSN ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- Highmark Health (Frankfort, KY)
- …consistent with established industry and corporate standards and are within the care manager 's professional discipline. + Function in accordance with applicable ... specialization + Experience in a clinical setting **Preferred** + Experience in UM/CM/QA/ Managed Care **LICENSES AND CERTIFICATIONS** **Required** + Current RN… more
- Veterans Affairs, Veterans Health Administration (Lexington, KY)
- …complex and intensive inpatient multidisciplinary program, they will provide direct patient care and ensure that patients discharged from inpatient care receive ... complete professional responsibility for his/her clinical assessment findings, patient care decisions, and documentation. Coordinating treatment planning and delivery… more
- Humana (Frankfort, KY)
- …the (appropriate state) with no disciplinary action. + An active designation as a Certified Care Manager (CCM). If no active designation as a CCM at hire date, ... holistic approach for case management throughout the continuum of care . The case manager will offer guidance,...delivery system. + Knowledge of MCG or Interqual. + Managed care experience. **Additional Information** **Work Days/Hours**… more
- CDM Smith (Lexington, KY)
- …CDM Smith currently has a new opportunity for a Senior Project Manager with previous experience managing industrial water and/or wastewater projects to join ... Smith's mission by: * Managing and serving as the lead Project Manager on water/wastewater projects * Providing technical guidance, senior leadership, and mentoring… more
- Molina Healthcare (Lexington, KY)
- …medical facilities, healthcare vendor, commercial health insurance company, large physician practices, managed care organization, etc.) + Strong Knowledge of SQL ... **Job Summary** The Manager , Medical Economics provides support and consultation to...medical coding/billing (UB04/1500 form) + Demonstrated understanding of key managed care concepts and provider reimbursement principles… more
- Molina Healthcare (Lexington, KY)
- …in health care field including, but not limited to, provider's office, managed care , or other health care field. **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS ... with leadership based on feedback rom assigned MHI attorney. * Assists Manager and/or Director in the negotiation of medical group/IPA and hospital contracting.… more
- CVS Health (Frankfort, KY)
- …utilizing and navigating multiple software programs concurrently. **Preferred Qualifications** - Managed care experience -Advanced training (ie, Board-certified ... requests pharmacist attendance for an onsite visit/assessment/audit. The Pharmacy Program Manager role includes: -Collaborate with an interdisciplinary care … more
- Stantec (Lexington, KY)
- When you care deeply about the work you do, it's rewarding to see it through from concept to completion. We partner with clients to provide both program management ... transit systems, water treatment facilities, mines, and wind farms, we've successfully managed thousands of projects. Joining our team, turning visionary ideas into… more
- Molina Healthcare (Lexington, KY)
- …equivalent combination of education and experience **Required Experience** * 3 years managed care experience, preferably with a national or multi-location ... **Job Description** **Job Summary** The In-Home Assessment Program Manager is part of our innovative Risk Adjustment...better support overall population heath management, reduce gaps in care and drive medical loss ratio (MLR) targets. In… more
- CVS Health (Frankfort, KY)
- …and with relevant external constituents** + **At least 3 years of experience in managed care which may include PBM, Pharma, market access, account management, ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
