- Bishop McCarthy Center (Vineland, NJ)
- Employee Heath/ Managed Care ...Control Registered Nurse has oversight over functions of the employee health program which include pre employment ... screening, employee verification, annual PPD testing, Covid testing, work related injury follow-up, knowledge of infection control practices. Case Manager ressponsciblitlies include gathering information to submit to insurnace companies for continued stay… more
- Hilton (Dover, DE)
- …bereavement days, flexible spending accounts, a health savings account, an employee assistance program, access to a care coordination program \("Wellthy"\), ... for eligible Team Members, including partners and adoptive parents + Mental health resources including free counseling through our Employee Assistance Program… more
- BAYADA Home Health Care (Cape May, NJ)
- **Cape Regional Home Health Care Managed by BAYADA** is looking for compassionate and dedicated **Full-Time, Part-Time, or per-diem** **Registered Nurses ... clients and their families deserve the highest quality home health care delivered with compassion, excellence, and...life insurance, 401k with company match, direct deposit and employee assistance program + To learn more about BAYADA… more
- Highmark Health (Dover, DE)
- …implement and evaluate care for eligible members with chronic and complex health care , social service and custodial needs in a nursing facility or ... address the member's specific needs. + Educate members or caregivers regarding health care needs, available benefits, resources and services including available… more
- Highmark Health (Dover, DE)
- …insurance experience + 1 year in a clinical setting **Preferred** + 5 years in UM/CM/QA/ Managed Care + 1 year in advanced training and experience in cognitive ... a number of other activities to help improve the health outcomes of members; care plans include...Practices and Information Security Policy._ _Furthermore, it is every employee 's responsibility to comply with the company's Code of… more
- Highmark Health (Dover, DE)
- …in home clinical or case management experience + Medicare and Medicaid experience + Managed care experience **SKILLS** + Leadership skills and be able to relate ... education services and 3 years of experience in long-term care , home health , hospice, public health...Practices and Information Security Policy._ _Furthermore, it is every employee 's responsibility to comply with the company's Code of… more
- Humana (Dover, DE)
- … first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical ... services such as inpatient rehabilitation **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage and Managed … more
- CVS Health (Bridgeton, NJ)
- …consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions ... of clinical experience** in settings such as hospitals, home health , or ambulatory care . + Willingness and...**case management** or **discharge planning** . + Background in ** managed care ** , **Medicaid/Medicare** , or **LTSS**… more
- Highmark Health (Dover, DE)
- …Doctor of Pharmacy degree + Active pharmacist license + 4 years of experience in managed care pharmacy + 2 years of clinical account management experience in ... Medicare as part of the 4 year managed care experience + 2 years of...with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as… more
- Highmark Health (Dover, DE)
- …in Medical Management in a Health Insurance Plan; strong knowledge of managed care industry **LICENSES AND CERTIFICATION** **Required** + Medical Doctor or ... + Listening + Telephone Skills + General Computer Skills + Clinical Software + Managed Care **Language (Other than English)** None **Travel Required** 0% - 25%… more
- Humana (Dover, DE)
- …plus + Stars, Risk Adjustment, or IHWA experience + Knowledge and experience in health care environment/ managed care **Additional Information** To ensure ... millions of people we serve to achieve their best health - delivering the care and service...the policy of Humana not to discriminate against any employee or applicant for employment because of race, color,… more
- Highmark Health (Dover, DE)
- …related area + 3 years Value-based reimbursement, through managed care contracting, provider reimbursement, consulting, population health delivery or related ... innovation. + Develop and maintains strategic provider relationships to understand the current health care delivery state, readiness for change, test value based… more
- CVS Health (Dover, DE)
- …consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions ... At CVS Health , we're building a world of health...internal and external partners **Required Qualifications** 5+ years of managed care experience 3+ years of compliance,… more
- CVS Health (Dover, DE)
- …consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions ... At CVS Health , we're building a world of health ...constituents** + **At least 3 years of experience in managed care which may include PBM, Pharma, market… more
- CVS Health (Dover, DE)
- …consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions ... At CVS Health , we're building a world of health...Experience in Healthcare Quality, CPHQ preferred. + Background in Managed Care . + Familiarity with claims processing… more
- CVS Health (Dover, DE)
- …consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions ... At CVS Health , we're building a world of health...role in maintaining quality standards and regulatory compliance across managed care operations. **Key Responsibilities:** + Lead… more
- Humana (Dover, DE)
- …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... as a focus on collaborative business relationships, value based care , population health , or disease or ...a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. +… more
- Humana (Dover, DE)
- …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... well as a focus on collaborative business relationships, value-based care , population health , or disease or ...a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. +… more
- Humana (Dover, DE)
- …services (such as inpatient rehabilitation). **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... as a focus on collaborative business relationships, value based care , population health , or disease or ...a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. +… more
- CVS Health (Dover, DE)
- …consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions ... At CVS Health , we're building a world of health...our initiative to modernize how data is accessed and managed , enabling teams across the company to easily work… more