- MetroPlusHealth (New York, NY)
- …a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care , Medicare, Child Health Plus, Exchange, Partnership in ... in collaboration with the CSS Medical CMs and Foster Care Liaison , as indicated. The Children's BH...(Serious Mental Illness & Substance Use Disorder) experience in managed care utilization review, quality assurance, discharge… more
- Abbott House (Bronx, NY)
- Job Summary: The Medicaid Managed Care Liaison is the primary contact person for the Medicaid Managed Care Plans (MMCP). MMC Liaison must ... + Medicaid Managed Care policies and procedure + The Medicaid Managed Care Liaison is a full-time position. Duties and Responsibilities: 29I… more
- AmeriHealth Caritas (Newtown Square, PA)
- …Experience:** + Required Bachelor's Degree. Master's Degree preferred. + 3 to 5 years Managed Care experience with Medicaid Market and/or other ancillary ... Medicaid Market executive leadership. + Acts as a liaison to operating entity and staff group organizations to...to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and… more
- Humana (Baton Rouge, LA)
- …communication skills + 5 years of established clinical experience + Knowledge of the managed care industry including Medicare, Medicaid and or Commercial ... hospital, LTAC, Acute rehab, SNF) according to the Humana Medicaid Model of Care . *Participate in Quality...with various providers and ancillary providers. *Serve as clinical liaison with inpatient facilities and joint operating committees to… more
- AdventHealth (Maitland, FL)
- …Provides guidance and direction to PFS, Central Denials, Patient Access and Managed Care staff regarding contract terms and policies including; governmental ... key contract data elements which are populated into the Managed Care database including addition of new...ensures expeditious handling of related issues. + Support and Liaison * Supports and serves as liaison … more
- Elderwood (Buffalo, NY)
- …the HMO Managed Care Insurance Companies + Knowledge of Medicare and Medicaid Managed Care Policies and Utilization Review. EOE Statement WE ARE AN ... Salary $20 - $22 / Hour Overview Therapy Managed Care Coordinator Be the vital... liaison between our skilled nursing facilities and managed care organizations. Your work ensures patients… more
- Elderwood (Waverly, NY)
- …the HMO Managed Care Insurance Companies + Knowledge of Medicare and Medicaid Managed Care Policies and Utilization Review. Managed Care ... Salary $ 20 / $ 22 Overview Managed Care Coordinator Overview Mon-Fri 8am-4pm... liaison between the SNF and the HMO Managed Care Insurance Companies. This includes all… more
- AbbVie (North Chicago, IL)
- …DO, Pharm.D. or Ph.D. + Three (3) to five (5) years of experience in a Managed Care /PBM, VA/DoD, CMS, State Medicaid , health care consulting, ... & Access department who uses clinical expertise and experience/ knowledge of managed care , health policy, and pharmacoeconomics to support AbbVie's scientific… more
- Molina Healthcare (Columbus, OH)
- …integrity and other cost recovery processes + Direct PM experience in Managed Care Operations (claims, system configuration, provider data management preferred) ... and appreciates the member environments we serve + Exposure to all Managed Care industry functional departments **JOB QUALIFICATIONS** **Required Education** +… more
- Molina Healthcare (MI)
- …with Medicaid contract analytics is highly preferred. + Experience working on Managed care analytics and healthcare reimbursement models is required. + Must ... Financial and Utilization Metrics of Healthcare. + Must be able to act as a liaison between Finance and Network Contracting as well as other external teams. + Must… more
- Molina Healthcare (Nampa, ID)
- …**Required Experience:** 3-5 years' experience in healthcare industry, preferably in the Medicaid Managed Care Programs Previous healthcare marketing and/or ... Molina Healthcare is hiring a Tribal Liaison in Idaho. This role is remote with...as claims or billing **Preferred Experience:** Experience in the Medicaid Managed Care Programs Experience… more
- Molina Healthcare (Reno, NV)
- …**Required Experience:** + 3-5 years' experience in healthcare industry, preferably in the Medicaid Managed Care Programs + Previous healthcare marketing ... Molina Healthcare is hiring for a Tribal Liaison . Candidates must live in Washoe County. There...working with the Native American population Experience in the Medicaid Managed Care Programs Experience… more
- Allaire Rehab & Nursing (Freehold, NJ)
- …+ Maintain a working knowledge of Federal and State regulations and reimbursement ( Managed Care , Medicare, and Medicaid ). + Provide assistance with ... Allaire Health Services is looking for a Marketing Liaison to join our incredible New Jersey team!...admissions process. + Maintain a strong working knowledge of managed care referral processes. + New Jersey… more
- Novant Health (Charlotte, NC)
- …years' experience in home care or hospice, required . Previous experience in managed care , infusion care , and case management and previous home ... Job Summary Hospice Liaison Nurse - Full-Time, Days Charlotte Hospice -...dignity, quality, and comfort at every step of the care journey. In this meaningful role, you'll clinically assess… more
- Humana (Jackson, MS)
- …community and help us put health first** The Senior TRICARE Community Liaison (TCL) is a customer-facing Humana Military associate who is knowledgeable, ... eligibility, enrollment, billing, claims, referrals/authorizations, network operations, access to care , Defense Health Agency/TRICARE Health Plan policy, and other… more
- Novant Health (Salisbury, NC)
- …three years' experience in home care or hospice, required. Previous experience in managed care , infusion care , and case management and previous home ... Job Summary Novant Health is seeking a Hospice Liaison Nurse. The Hospice Liaison Nurse... Nurse clinically assesses and admits patients to Hospice care as well as facilitates discharge planning from the… more
- Centers for Independence (Milwaukee, WI)
- …**Knowledge, Skills, & Abilities:** + Some understanding of long-term care , disabilities, Medicaid , managed care and/or Medicare is preferred + Ability ... **On Site Participant Liaison Field Rep - iLife** **Job Details** **Job...- Social Services **Description** **Job Purpose** : The Participant Liaison Field Representative ensures optimal service is provided to… more
- Centene Corporation (Harrisburg, PA)
- …processing, provider billing, or provider relations experience, preferably in a managed care environment. Knowledge of provider contracts and reimbursement ... claims payment expert for the Plan and as a liaison between the plan, claims, and various departments to...ensure configuration, state mandates, benefits, etc. + Review all Medicaid Bulletins for changes and updates and submit change… more
- Centene Corporation (Little Rock, AR)
- …Work licensure preferred. **Preferred Qualifications:** + Experience in quality healthcare and managed care environments + Strong understanding of HEDIS, STARS, ... and maintains provider relationship across all product lines (Medicare, Medicaid , Ambetter). Supports the development and implementation of quality improvement… more
- Somatus (Falls Church, VA)
- …including Group Health Plans (GHPs), Medicare, Medicaid , and managed care plans. Serve as a liaison between patients, insurance companies, and the ... Overview As the largest and leading value-based kidney care company, Somatus is empowering patients across the country living with chronic kidney disease to… more
