- Neighborhood Health Plan of Rhode Island (Smithfield, RI)
- …field in lieu of a degree Minimum of five (5) years' experience with a managed care organization or a health care related organization (HMO; ... Category Professional / Experienced Description The Policy and Claims Research Specialist is responsible for supporting the Payment Integrity initiatives and… more
- COOLSOFT (Raleigh, NC)
- …alternatives for business solutions. - Preferred to have experience with Medicaid, managed care , and Pharmacy Benefit Manager (PBM) operations. areas. - ... Excellent Communication Skills HIPPA Specialist (Jobs in Raleigh, NC) Requirement id 155692...Skills HIPPA Open Date 24-Oct-2025 Close Date Job type Contract Duration 10 Months Compensation DOE Status requirement Job… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …collections of outstanding account balances for commercial, government, and managed care payors as assigned. The Reimbursement Specialist I is required to ... their leadership. It is a requirement for the Reimbursement Specialist I to read, interpret and apply complex payor... I to read, interpret and apply complex payor contract language to expected reimbursement calculations and pursue all… more
- MaineGeneral Rehabilitation and Long Term Care - Gray Birch (Augusta, ME)
- Details Client Name MaineGeneral Rehabilitation and Long Term Care - Gray Birch Job Type Travel Offering Nursing Profession RN Specialty Skilled Nursing Job ID ... Night Shift (7 PM - 7 AM) Location: Long-Term Care (LTC), Skilled Nursing Facility (SNF), Acute Rehabilitation, Residential...are from 6:45 PM to 7:15 AM, with scheduling managed by the team manager Additional Information: - Dress… more
- LBH - Levindale Hebrew Geriatric Center and Hospital (Baltimore, MD)
- …20 semi-private rooms and accommodates up to 40 patients requiring advanced medical care . Patients may be managed for acute brain injuries, respiratory ... Description Job Title: Night Shift Nurse - High Intensity Care Unit (HICU) Location: Maryland (or Compact License accepted)...the flexibility to choose between a 36 or 48-hour contract , with a requirement to work every other weekend.… more
- AccentCare, Inc. (Dallas, TX)
- Overview Managed Care Contract Specialist Location: Dallas Corporate Office Position: Managed Care Contract Specialist Position Type: ... Salary: $55,000 to $63,000 per year DOE Find Your Passion and Purpose as a Managed Care Contract Specialist What You Need to Know Reimagining Your Career… more
- Cedars-Sinai (CA)
- **Job Description** The Managed Care Compliance Specialist is responsible for assisting with the implementation of the internal auditing and monitoring ... contract language for Commercial, Medicare and Medi-Cal managed care . + Acts as a liaison...and beyond. **Req ID** : 11981 **Working Title** : Managed Care Compliance Specialist -… more
- Community Health Systems (Franklin, TN)
- …identifying claim issues, and ensuring timely resolution in compliance with government and managed care contract terms. This role requires effective ... **Job Summary** The Collections Specialist I is responsible for performing collection follow-up...people get well and live healthier. CHS operates 71 acute- care hospitals and more than 1,000 other sites of… more
- New York State Civil Service (West Seneca, NY)
- NY HELP Yes Agency People With Developmental Disabilities, Office for Title Contract Management Specialist 1 - EOA#25-583jh Occupational Category Other ... within the Regional Field Office 1 organizational structure. The Contract Management Specialist 1, specific duties will...Plan. * Voluntary pre-tax savings programs such as Health Care Spending Account and the Dependent Care … more
- New York State Civil Service (NY)
- NY HELP Yes Agency People With Developmental Disabilities, Office for Title Contract Management Specialist 1 Occupational Category Other Professional Careers ... within the Regional Field Office 1 organizational structure. The Contract Management Specialist 1, specific duties will...Plan. * Voluntary pre-tax savings programs such as Health Care Spending Account and the Dependent Care … more
- JPMorgan Chase (Columbus, OH)
- …center of high-impact collaboration with senior leaders and industry experts. As the Contract Specialist within JP Morgan's Asset Management you are an ... Take charge of the contract management process for JP Morgan's diverse investment...Mutual Funds, Global Liquidity, 529, Commingled, ETF, Alternatives and Managed Account businesses. This includes responsibility for the approval… more
- Motion Recruitment Partners (Alpharetta, GA)
- …not be excluded from consideration. + A minimum of 2 years related experience ( Managed Care or Medical/Dental Insurance experience). + Ability to clearly present ... Provider Administration Specialist / Contract / Hybrid /...+ Health Savings Account (HSA) + Health and Dependent Care Flexible Spending Accounts + Voluntary Life Insurance, Long-Term… more
- Pacific Medical Centers (Renton, WA)
- …the best people, we must empower them. **Required Qualifications:** + 5 years Managed care operations. + Extensive experience and understanding of capitated ... there is compliance with all elements of the TRICARE Management Activity contract . Understands the attitudes and values of the community and establishes effective… more
- Guidehouse (San Antonio, TX)
- **Job Family** **:** Financial Account Specialist **Travel Required** **:** None **Clearance Required** **:** Ability to Obtain Public Trust **What You Will Do** ... components. * Provides oversight and executive level management to overcall contract operations often involving multiple projects/tasks and groups of personnel at… more
- HCA Healthcare (Campbell, CA)
- …of health plan economics analyses, metrics and health plan reporting in a Managed Care environment relating to the financial, quality and operational performance ... Come join our team as a Health Plan Economics Specialist . We care for our community! Just...for Health plan Metrics, Analytics and Reporting for a Managed Care organization + Develop and maintain… more
- MSys Inc. (Raleigh, NC)
- …strategic alternatives for business solutions. + Preferred thave experience with Medicaid, managed care , and Pharmacy Benefit Manager (PBM) operations. areas. + ... Job summary: Title: PBM Business Integration Specialist - Hybrid Location: Raleigh, NC, United States...Experience handling HIPPA and PII data. 3 years + Managed care knowledge or experience. 3 years… more
- New York State Civil Service (Rome, NY)
- …People With Developmental Disabilities, Office for Title Human Resources Specialist 1/Trainee 1/2 Occupational Category Administrative or General Management Salary ... State NY Zip Code 13440 Duties Description Under the direction of a Human Resources Specialist 2, the Human Resources Specialist 1 will provide a full range of… more
- Prime Care Coordination (Webster, NY)
- …and/or DOH regulations, programs, and service delivery systems including Medicaid Service Coordination, Care Coordination, Managed Care , Health Home Care ... Summary: The Senior Compliance and Quality Specialist is responsible for coordinating and monitoring PCC's...+ Minimum 2 years of experience within a health care or human services setting. + Possession of valid,… more
- Spokane County (Spokane, WA)
- …the timelines established for service delivery and to meet the Washington State Health Care Authority (HCA), DOH, Managed Care Organization (MCO), and SCRBH ... Housing & Community Support Specialist 1 Print (https://www.governmentjobs.com/careers/spokanecountywa/jobs/newprint/4913284) Apply Housing & Community Support … more
- Robert Half Office Team (Richmond, VA)
- …the opportunity to apply your expertise in credentialing processes and compliance within the managed care sector. Join a dynamic team where your skills will ... for healthcare providers, ensuring compliance with Medicare, Medicare Advantage, and managed care organization standards. * Manage the end-to-end credentialing… more
