- BayCare Health System (Clearwater, FL)
- …of trust, dignity, respect, responsibility and clinical excellence. **Responsibilities:** + The Managed Care Financial Analyst Sr. performs financial ... team member be working remotely?** Hybrid Equal Opportunity Employer Veterans/Disabled **Position** Managed Care Financial Analyst Sr **Location** Clearwater… more
- Hartford HealthCare (Wethersfield, CT)
- …**Job:** **Administrative* **Organization:** **Hartford HealthCare Corp.* **Title:** *Senior Payer Analyst / Managed Care Contracting* **Location:** ... the Manager of Payer Contract Analytics, the Sr. Payer Analyst develops a modeling process for negotiated rate changes...develops a modeling process for negotiated rate changes with Managed Care payors for hospital services. Develops… more
- e CancerCare (Nashville, TN)
- …related to ION network and providers. Team member will work closely with the Managed Care department team in generating and reviewing system data, while making ... other internal teams with reimbursement related concerns and acting as a liaison to managed care plans. Essential Functions: . Support Managed Care team… more
- Hawaii Pacific Health (Honolulu, HI)
- …training, as well as internal peer equity. Starting Hourly Rate: 30.47 **Position** Analyst - Analytics Managed Care **Category** Administrative **Employment ... The department also performs additional services in collaboration with the managed care services department including referral management, patient steerage,… more
- Rush Copley Medical Center (Aurora, IL)
- Responsible for analyzing the hospital's current accounts receivable for Medicaid Managed Care , finding underpayments and rebilling the insurance carriers to ... management. Responsible for accurate knowledge of and familiarity with, major managed care contracts, referencing contracts as needed. Must have EPIC experience… more
- Queen's Health System (Honolulu, HI)
- …A. EDUCATION/CERTIFICATION AND LICENSURE: * Bachelor's degree in Business, Finance or Health Care Administration or four (4) years with health care provider or ... to the educational requirement, two (2) years experience with a health care provider or payer in contracting or business operations. * Demonstrated ability… more
- Highmark Health (Columbus, OH)
- …:** **GENERAL OVERVIEW:** This role processes payor contracts for single case agreements, manages contract repository, and completes facility credentialing ... applications. Disseminates payor communications and coordinates projects as assigned. Summarizes contract terms and payor policies for use throughout the organization. Provides accurate hospital, professional, and ASC rate information to Leaders throughout the… more
- Sharp HealthCare (San Diego, CA)
- …spreadsheets and databases. **What You Will Do** Under the direction of the Director of Managed Care Finance and Supervisor of Managed Care Finance ... + Bachelor's Degree or equivalent work experience. + Previous experience in a managed care setting. + Working knowledge of hospital, physician and health care… more
- J&J Family of Companies (Raritan, NJ)
- … is responsible for supporting the contracting needs for Pharmacy Benefit Managers (PBM), Managed Care Organizations (MCO) and Long Term Care (LTC) GPOs ... Sr. Analyst , Managed Markets & Specialty - 2406181693W **Description** Johnson & Johnson Health Care Systems Inc., a member of Johnson & Johnson's Family of… more
- Hartford HealthCare (Wethersfield, CT)
- …programs and other common practices across the system. *_Position Summary:_* The Managed Care Contracting organization is seeking a results-oriented, committed, ... Query Language (MSSQL) Database skills to lead/execute the development of the complex Managed Care / Payer Analytics platform. The Payer Analytics team is… more
- MyFlorida (Tallahassee, FL)
- …does this specifically through audits and investigations of healthcare providers, including managed care plans, suspected of engaging in fraudulent or abusive ... 68019462 - MEDICAL/HEALTH CARE PROGRAM ANALYST Date: Mar 21,...responsibility: Fraud and Abuse Detection, Prevention, Overpayment Recovery, and Managed Care oversight. MPI operates with dynamic… more
- City and County of San Francisco (San Francisco, CA)
- Behavioral Health Services (BHS) is increasingly expanding services under its Managed Care division which oversees the Office of Coordinated Care (OCC), ... psychiatric services. The Behavioral Health Services (BHS) Deputy Medical Director of Managed Care provides effective leadership and strategic direction in the… more
- MyFlorida (Tallahassee, FL)
- …does this specifically through audits and investigations of healthcare providers, including managed care plans, suspected of engaging in fraudulent or abusive ... 68055653 - MEDICAL/HEALTH CARE PROGRAM ANALYST Date: Apr 10,...responsibility: Fraud and Abuse Detection, Prevention, Overpayment Recovery, and Managed Care oversight. MPI operates with dynamic… more
- LA Care Health Plan (Los Angeles, CA)
- …implementation, and administration of Community Health department initiatives that improve both the managed care performance of the LA County safety net and the ... As part of the Community Health Department, the Program Analyst will help LA Care and its...issues. Experience working with Los Angeles safety net providers. Managed health care experience. Skills Required: Demonstrated… more
- LA Care Health Plan (Los Angeles, CA)
- …in designing, developing, generating and analyzing ad hoc/production reports in Healthcare/ Managed Care setting. Preferred: Experience as a Clinical Data ... Clinical Data Analyst III Job Category: Clinical Department: Quality Improvement...$115,509.00 (Mid.) - $142,166.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created… more
- HCA Healthcare (Nashville, TN)
- …the Legal Department to support all phases of the arbitration and/or litigation of managed care disputes. This paralegal position will have responsibility for a ... wide variety of managed care litigation tasks, including: handling service...attorneys currently are supported by one litigation paralegal, one analyst and eight contract attorneys. Litigation paralegals are assigned… more
- State of Michigan (Lansing, MI)
- …data warehouse reporting associated with Michigan's current and any future expansions of managed care dental programs (Healthy Kids Dental and Healthy Michigan ... Departmental Analyst 9-P11 - Rates and Encounter Data Section...Kids Dental encounter data, responsible for the oversight of managed care encounter submissions for the Rates… more
- AdventHealth (Maitland, FL)
- …ethic, trainability, communicative, team player, and strong analytical skills The Senior Medical Economics Analyst will work with managed care staff for both ... analyzing and evaluating financial and economic data related to healthcare costs and managed care payer rates and reimbursement. The role focuses on financial… more
- LA Care Health Plan (Los Angeles, CA)
- …practices. Preferred: At least 5 years experience working with a California Medi-Cal managed care plan or commercial health plan, medical group, or management ... Surround Systems Configuration Analyst III (Temporary) Job Category: Information Technology Department:...services organization. Skills Required: Advanced understanding of managed care operations (including, but not limited… more
- LA Care Health Plan (Los Angeles, CA)
- …the Claims Operation process and oversight on metrics as well as other related managed care service activities for the Claims Department. Finally, the position ... Compliance and technical staff. The Claims Compliance Data Validation Analyst also ensures that LA Care 's Claims...'s Claims Department is compliant with all Department of Managed Health Care (DMHC), Medi-Cal, Centers for… more