- MaineGeneral Health (Waterville, ME)
- …seeking a finance professional to join our experienced team as the Director of Reimbursement and Managed Care who will oversee all aspects of ... reimbursement , managed care contracts, and payer enrollment. The successful candidate will have a deep understanding of healthcare finance, regulatory… more
- Highmark Health (Augusta, ME)
- …Healthcare, Healthcare Insurance, Consulting or related area + 3 years Value-based reimbursement , through managed care contracting, provider reimbursement ... **JOB SUMMARY** This job owns the strategic design and analytical approach to reimbursement . In order to be successful, the incumbent will work closely with… more
- Otsuka America Pharmaceutical Inc. (Augusta, ME)
- …program. This role will oversee nurse case managers, ensuring high-quality patient care and operational excellence in our support services, inclusive of medication ... in-field visits and call and case monitoring, maintaining high standards of patient care + Collaborate closely with compliance and legal teams to ensure adherence to… more
- Covenant Health (Lewiston, ME)
- …periods calmly, coordinating discharge needs across all disciplines. + Verify managed care company rates and insurance coverage, obtaining pre-certification ... Summary Under the guidance of the Director of Nursing, the Care Coordinator...policies. + Familiarize with acceptable diagnoses for admissions and reimbursement . + Maintain patient safety through infection control measures… more
- Martin's Point Health Care (Portland, ME)
- …and/or Certification(s): + Unrestricted state license as a Registered Nurse + Certification in managed care nursing or care management desired (CMCN or CCM) ... Join Martin's Point Health Care - an innovative, not-for-profit health care...and retrospective review) for medical necessity referring to Medical Director as needed for additional expertise and review. +… more
- Central Maine Medical Center (Lewiston, ME)
- …with outside regulatory requirements are documented (ie Pricing Transparency, CMS regulations, Managed Care contract terms) Management Reporting and Monitoring + ... At Central Maine Healthcare our team members are committed to providing exceptional care and experiences for our community and for each other every day. Central… more