- Cyfle (Washington, DC)
- About the job Consulting Professional - Value-Based and Managed Care Regulatory and Policy We have partnered with a large law firm in the Washington, DC area to ... provide them with a Consulting Professional - Value-Based and Managed Care Regulatory and Policy. Please review the below description and let us know if you are… more
- iCare Health Solutions Enterprise (Miami, FL)
- …NextGen Contract Utility, supporting both traditional fee-for-service (FFS) reimbursement and managed care models, including capitated, global payment, and ... seamless implementation of negotiated agreements Act as the liaison between Managed Care , Revenue Cycle, IT, and Clinical Operations for contract-related system… more
- CommuniCare Family of Companies (Cincinnati, OH)
- CommuniCare Health Services is currently recruiting a Corporate Accounts Receivable / Managed Care Support Specialist. PURPOSE / BELIEF STATEMENT The A/R ... Managed Care Support Specialist will assist in the timely and expedited collection of cash from managed care payors. This role is expected to provide… more
- Teva Pharmaceuticals (Parsippany, NJ)
- …and new people to make a difference with. The opportunity The Associate Director, Managed Care Payer Analytics is responsible for leading the analytical strategy ... SQL, and data visualization tools (eg, Tableau, Power BI). Experience with managed markets data sources such as customer portal, claims, rebate submissions and… more
- PIH Health (Whittier, CA)
- …for training employees to perform accurate and timely follow up of Commercial and Senior Managed care claims and all payer mix through resolution. Serves as a ... adjustments, write-offs, credit balances, and correspondence from various Medi-Cal and or Managed Care HMO Plans. Review of Medi-Cal and Managed Care… more
- McLaren Health Care Corporation (Flint, MI)
- …field. Five (5) years' experience performing quality management activities in a managed care organization, including HEDIS, NCQA, including at least two ... (MIG) is a fully owned subsidiary of McLaren Health Care Corporation and is the parent company of McLaren...our Michigan-based health plan dedicated to meeting the health care needs of each of our Michigan members. Learn… more
- CSI Pharmacy (Nash, TX)
- Job Title CSI Director of Managed Care (S) Location Remote/Nationwide, USA Additional Location(s) Employee Type Employee Working Hours Per Week 40 Job ... Description Leads the implementation process of managed care contracts and develops and maintain systems to disseminate contract information Manages the… more
- Nascentia Health (Syracuse, NY)
- The Managed Care Scheduling and Mailing Coordinator provides administrative and scheduling support to the Care Coordinators, Utilization Management and ... letters and other mailings as needed. Coordinates and assists with contacting managed care applicants for scheduling enrollment assessments for the Assessment… more
- Butler Hospital (Providence, RI)
- …performance and conditions of employment applicable to employees of Butler Hospital. Care New England Health System (CNE) and its member institutions, Butler ... Hospital, Women & Infants Hospital, Kent Hospital, VNA of Care New England, Integra, The Providence Center, and ...Care New England, Integra, The Providence Center, and Care New England Medical Group, and our Wellness Center,… more
- Novo Nordisk Inc. (Dayton, OH)
- …elements in the market to identify and leverage business opportunities Analyze impact of managed care in the territory and its effect on prescribing decisions, ... objectives and align to audience needs Leverage understanding of impact of managed care in the territory and how it affects physicians prescribing decisions, and… more
- Novo Nordisk Inc. (Hackensack, NJ)
- …elements in the market to identify and leverage business opportunities Analyze impact of managed care in the territory and its effect on prescribing decisions, ... Novo Nordisk, we are the world leader in diabetes care and a major player in defeating other serious...with other field-based employees (eg, DBMs, IDBMs, DCSs, IDCSs, Managed Markets Sales Team, Diabetes Educators, Medical Liaisons) covering… more
- Athena Health Care Systems (Southbridge, MA)
- …members on non-completed sections of MDS. Retrieves/Prints and faxes medical records to managed care companies for utilization review purposes. Transmits MDSs to ... individuals, regardless of personal characteristics, are encouraged to apply. Athena Health Care Systems and its managed facilities/agencies follow federal and… more
- Alliance For Better Health Care LLC (Glens Falls, NY)
- …Minimum 5+ years of related experience in a clinical, non-profit, or Managed - Care Organization (MCO) environment preferred. Knowledge, Skills, and Abilities ... same opportunity to be healthy. Designated as the Social Care Network (SCN) Lead Entity for the Capital Region,...and navigation activities for Medicaid Fee-for-Service Members and certain Managed Medicaid Members. We are looking for someone who… more
- HCR Home Care (Queensbury, NY)
- …the client's care to effectively reduce duplicative services. Consult with the physicians, Managed Care Organizations and other members of the Care Team ... Role and Responsibilities The Health Home Care Manager will provide collaborative, client-centered support to Health Home Program clients using the development of… more
- Pyramid Consulting, Inc. (Wolfforth, TX)
- …, or community setting and 1+ years of case management experience in a managed care setting. Knowledge of utilization management principles and healthcare ... managed care . Experience with medical decision support tools (ie Interqual, NCCN) and government sponsored managed care programs. Bilingual (Spanish). 2+… more
- Lakeland Care, Inc. (Fond Du Lac, WI)
- …on creating a world we all want to live in. With long-standing roots as a managed care organization (MCO), we provide long-term care services to eligible ... we serve members in your area! Position Summary: The Care Manager (CM), as part of an interdisciplinary team...part of an interdisciplinary team (IDT) with a RN Care Manager (RN CM), serves Lakeland Care 's… more
- Lakeland Care, Inc. (Madison, WI)
- …on creating a world we all want to live in. With long-standing roots as a managed care organization (MCO), we provide long-term care services to eligible ... serve members in your area! Position Summary: The RN Care Manager (RN CM), as part of an interdisciplinary...as part of an interdisciplinary team (IDT) with a Care Manager, serves Lakeland Care 's (LCI) members,… more
- Metropolitan Jewish Health System (New York, NY)
- …continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are ... with the PCP, caregivers and other team members, to help meet the member's needs. managed care nurse, managed care rn, nursing, rn, nurse, care … more
- Novo Nordisk Inc. (Traverse City, MI)
- …in order to influence formulary status, as applicable May analyze impact of managed care in the territory and its effect on prescribing decisions, ... who need them most. At Novo Nordisk, we are the world leader in diabetes care and a major player in defeating other serious chronic conditions such as obesity,… more
- State of Oregon (Portland, OR)
- …team oversees and ensures compliance with federal regulations for Oregon's Medicaid Managed Care program. The team is responsible for quality management ... quality control, assurance, planning, improvement initiatives, and contractual oversight of Managed Care Organizations (MCOs). The unit collaborates with… more
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