- 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
- COPE Health Solutions (San Francisco, CA)
- …or Education, Training and Experience Valid and current LCSW or LMSW licensure 3-5 years' care management and/or managed care experience in one of the ... Description The Licensed Clinical Social Worker (LCSW), Care Management, will work...Vice President & Principal Direct Reports (8) Community Health Workers , (4) Patient Care Navigators Location San… 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
- Community Health Centers, Inc. (Winter Garden, FL)
- …billing procedures for Medicare/Medicaid, Workers Compensation, HMOs, PPOs and other managed care and commercial insurance plans. Must have knowledge of ... Billing Representative - Winter Garden/Remote after 90 days *Position...claims for accuracy in accordance with Medicare, Medicaid and Managed Care policies. Transfers balances to patient's… more
- Children's National Hospital (Rockville, MD)
- …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
- Desire In Home Care (Overland Park, KS)
- Independent Sales Representative (1099) - Home Care Services Location: Missouri & Kansas (Remote / Field-Based) Job Type: Independent Contractor (1099) Company: ... Desire In-Home Care Desire In-Home Care is a licensed...professionals with excellent communication and relationship-building skills Self-motivated, independent workers comfortable managing their own schedule Compassionate and patient… more
- Children's National Hospital (Silver Spring, MD)
- …ensure accuracy. May provide required notification of scheduled services according to managed care requirements. May be responsible for scheduling patients for ... future). Information Verification Verify insurance eligibility using applicable eligibility system. Ensure managed care carve outs (lab and radiology carve outs)… more
- Blue Cross and Blue Shield of Minnesota (Duluth, MN)
- …to work in the US Preferred Skills and Experiences 1+ years of managed care experience; eg case management/health coach, utilization management and/or auditing ... member needs and opportunities. Collaborates and communicates with member, family, or designated representative on a plan of care that produces positive clinical… more
- Buena Vista Palliative Care, Home Health, & Hospice (Los Angeles, CA)
- …responding to customer requests and concerns, and negotiating service contracts with managed care organizations, government agencies, and other payers. DUTIES & ... develops and maintains relationships with physicians, discharge planners, case managers, social workers , and other health care professionals who utilize home … more
- NorthBay Health (Fairfield, CA)
- …of the unique characteristics of the following insurance types: Medi-Cal, Medicare, Managed Care , Indemnity and Workers Compensation. Impact of ... Job Description At NorthBay Health, the Patient Services Representative II performs general front office duties of...the well-being of our community by providing accessible, high-quality care to all who need it. Every member of… more
- FTI Consulting, Inc (New York, NY)
- …level of detail and complexity Participate in complex litigation engagements Representative underwriting audits may include, Workers ' Compensation, General ... planning tools, virtual expert coaching services and flex return support. Family care benefits, including back-up child/elder care Employee wellness platform… more
- LCB Senior Living (Easton, MA)
- …attitude towards the service provided. LCBs Non-Discrimination Policy: LCB, including its managed care communities, is an Equal Opportunity Employer. Recruitment ... of experience** 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
- LCB Senior Living (Ipswich, MA)
- …(either Category 1 or 2). LCBs Non-Discrimination Policy: LCB, including its managed care communities, is an Equal Opportunity Employer. Recruitment and ... and RESPONSIBILITIES: The essential duties and responsibilities described below are representative of those an associate encounters while performing the basic… more
- Hilton Garden Inn (Albany, NY)
- JOB SUMMARY The Guest Representative is responsible for the preparation and disposition of all night audit checklist work and reports. He/She/They is also ... actively develop superior service skills in dealing with clients, guest, and co- workers . QUALIFICATION STANDARDS EDUCATION & EXPERIENCE Experience in hotel or a… more
- Thomas Jefferson University Hospitals, Inc. (Camden, NJ)
- … care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage ... General Summary: The Guest Services Coordinator acts as the primary visitation representative for hospital patients, empathizing with patients and their family. This… more
- Baystate Health (Springfield, MA)
- Certified Pharmacy Technician-Acute Care GREAT WORK SCHEDULE: Part-time 32 hours (8-hr shifts) Days/Evenings based on department needs Every third weekend plus ... part-time, with full benefits , Certified Pharmacy Technician in Acute Care Pharmacy. DEPARTMENT DESCRIPTION: Strong Leadership Structure Awards for Unit Department,… more
- Sea Mar Community Health Centers (Monroe, WA)
- …Health Organization, County, and/or MCO contracts with the ability to tier clients in a managed care system. The ability to work effectively with all persons and ... recommendations. It is suggested that this individual communicate with the Primary Care Physicians, Substance Abuse Counselors, schools, case workers , or others… more
- Thomas Jefferson University Hospitals, Inc. (Montgomery, 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 ... Job Details The Specialty Pharmacy Representative I drives our refill queues and assists...distribution of prescriptions, under the direction of a patient care pharmacist, in accordance with the law. Job Description… more
- American Health Partners (Twin Falls, ID)
- …with patient needs, clinical circumstances and benefit coverage *Participate in all Managed Care related audits; generate, maintain and track reports and ... managed careo 3-5 years' experience performing case management within a managed care environment License/Certification(s): o Current state Registered Nursing… more
- WVU Medicine (Uniontown, PA)
- …payors as needed. 18. Educates hospital staff and physicians to payer regulations and managed care principals to prevent denials. 19. Fosters the integration of ... including denial management, utilization management, access to the appropriate level of care , discharge planning, care facilitation, and referral to other levels… more
