- Merck & Co. (Rahway, NJ)
- …meta-analyses, and economic modelling. Key responsibilities also include development of American Managed Care Pharmacy (AMCP) dossiers for US payers, and Global ... and standards, including Good Pharmacoepidemiology Practice (GPP) for applicable work.-Develops American Managed Care Pharmacy (AMCP) dossiers for US payers, and… more
- Thomas Jefferson University Hospitals, Inc. (Camden, NJ)
- …EPIC, Cerner Knowledge of medical terminology and/or third-party insurance coverage including managed care plans Strong verbal and written communication and ... care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage… more
- Children's National Hospital (Washington, DC)
- …future). Information Verification Verify insurance eligibility using applicable eligibility system. Ensure managed care carve outs (lab and radiology carve outs) ... office or scheduling coordinator to address issue timely without delaying patient care . Notify parents of the need for completed insurance referral form or… more
- Supernus Pharmaceuticals, Inc. (Rockville, MD)
- …key customers Assist with special projects as assigned by management (ie managed care pull-through programs, pre-launch initiatives, customer support outside of ... which they must convey detailed or important spoken instructions to other workers accurately, loudly, or quickly. Compensation: At Supernus, we offer a competitive… more
- CVS Health (Newark, NJ)
- …component Preferred Qualifications: Case management and/or discharge planning experience Managed Care experience Crisis intervention skills LTSS experience ... continued employment. The care manager is responsible to coordinate and collaborate care with member/authorized representative , PCP, and any other care … more
- Supernus Pharmaceuticals, Inc. (Allentown, PA)
- …key customers. Assist with special projects as assigned by management (ie managed care pull-through programs, pre-launch initiatives, customer support outside of ... which they must convey detailed or important spoken instructions to other workers accurately, loudly, or quickly. Compensation: At Supernus, we offer a competitive… more
- The Salvation Army Central Territory (Chicago, IL)
- …team-focused manner with the entire Lodge staff. OUTCOMES Information is processed and managed in a way that complies with policy, procedure, and mandate. This will ... according to industry standards and requests for information are efficiently managed for the Metropolitan Division. ESSENTIAL DUTIES AND RESPONSIBILITIES Case… more
- Strategic Health Partners (Kennesaw, GA)
- …a requirement *Ability to problem-solve & troubleshoot insurance claim *Working knowledge of Managed Care , Medicare and Medicaid *Knowledge of Word and Excel ... The Accounts Receivable representative is responsible for ensuring all eligible accounts...including knowledge of commercial, Medicare, Medicaid, VA, Tricare and Worker 's Comp payers. Insurance Follow-up required and Billing knowledge… more
- Brett/Robinson (Gulf Shores, AL)
- …on-site activities, and ensuring that our small shops remain organized, clean, and well- managed in terms of inventory control. With the ability to delegate tasks to ... improvement. Essential Functions and Responsibilities: Serve as an exemplary representative of Brett/Robinson, embodying courtesy, tact, consideration, and discretion… more
- LCB Senior Living (Bala Cynwyd, PA)
- …attitude towards the service provided. LCBs Non-Discrimination Policy: LCB, including its managed care communities, is an Equal Opportunity Employer. Recruitment ... with seniors SUMMARY : Active member of the Resident Care Team and assists the Resident Care ...FUNCTIONS: The essential duties and responsibilities described below are representative of those an associate encounters while performing the… more
- PVH Corp. (Palmetto, GA)
- …equipment are maintained in like new fashion Ensures assistant supervisors and warehouse workers are properly managed by supervisors at all times. Maintains ... $200 a year in rewards for exercising and participating in healthy activities. Care .com Services: Access to services for childcare, elder care , adoption… more
- Alignment Healthcare (San Diego, CA)
- …disabilities to perform the essential functions. Minimum Experience: 10 years of experience in managed care or health care field, including a strong ... reimbursement methodologies, contract language, negotiation strategies, financial modeling and analysis, managed care and Medicare Advantage plans; or any… more
- Zenith (Sarasota, FL)
- …and bill auditing experience. Experience with/understanding of utilization/bill review, claims, managed care processing; Workers ' Compensation Bill Audit ... and analysis and appropriate adjustment of billing as needed based on Workers Compensation fee schedules and guidelines or other jurisdictional pricing applications.… more
- American Health Partners (Acworth, GA)
- …with patient needs, clinical circumstances and benefit coverage *Participate in all Managed Care related audits; generate, maintain and track reports and ... the geriatric population o Two (2) years' experience in managed care 3-5 years' experience performing case...put success of team above own interests. Communicate with co- workers at all levels to adequately meet the needs… more
- Live Nation Entertainment, Inc. (Philadelphia, PA)
- …a Great Place to Work organization and one of People Magazine's "50 Companies that Care ". We want everyone to feel like they belong and can thrive in our community, ... application Workday and ensures that all employee data is managed properly Actively manage all aspects of special events...Maintains and monitors records of all incident reports and workers comp claims- investigates and manages all pending cases,… more
- Corvel (Lawrenceville, GA)
- …Demonstrated experience in management or supervision Training within the insurance industry, managed care or related field preferred PAY RANGE: CorVel uses ... account and large account will have an RVP assigned as a senior operations representative to the account Surface issues or potential issues to appropriate members of… more
- Ochsner Health (Kaplan, LA)
- …illness and/or trauma upon the patient and their support system. Advanced knowledge of managed care and public programs such as those funded by Medicare, ... each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations… more
- Thomas Jefferson University Hospitals, Inc. (Philadelphia, PA)
- … care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage ... occur before mid-semester. Interface with clinical preceptor as JCN's representative and liaison, encouraging communication and clinical professional relationships… more
- Ketchikan Indian Community (Ketchikan, AK)
- …+ Knowledge: Familiarity with programmatic and clinical research strategies in managed care settings preferred. Necessary Knowledge, Skills, and Abilities ... General Information Job Title: Medical Social Worker Contact: Human Resources, ### Date Posted: 05/21/2025... (MSW) will, in accordance with the plan of care , assist the medical provider and other team members… more
- Ochsner Health (Slidell, LA)
- …and/or trauma upon the patient and their support system. + Advanced knowledge of managed care and public programs such as those funded by Medicare, Medicaid, ... use of the company and community-based services. **LCSW (Licensed Clinical Social Worker )** Sign-on bonus up to $15,000 available for eligible LCSWs. **Education**… more
