• Neighborhood Health Plan of Rhode Island (Smithfield, RI)
    …field in lieu of a degree Minimum of five (5) years' experience with a managed care organization or a health care related organization (HMO; ... Category Professional / Experienced Description The Policy and Claims Research Specialist is responsible for supporting the Payment Integrity initiatives and… more
    Upward (07/31/25)
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  • MaineGeneral Rehabilitation and Long Term Care - Gray Birch (Augusta, ME)
    Details Client Name MaineGeneral Rehabilitation and Long Term Care - Gray Birch Job Type Travel Offering Nursing Profession RN Specialty Skilled Nursing Job ID ... Night Shift (7 PM - 7 AM) Location: Long-Term Care (LTC), Skilled Nursing Facility (SNF), Acute Rehabilitation, Residential...are from 6:45 PM to 7:15 AM, with scheduling managed by the team manager Additional Information: - Dress… more
    Upward (08/12/25)
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  • LBH - Levindale Hebrew Geriatric Center and Hospital (Baltimore, MD)
    …20 semi-private rooms and accommodates up to 40 patients requiring advanced medical care . Patients may be managed for acute brain injuries, respiratory ... Description Job Title: Night Shift Nurse - High Intensity Care Unit (HICU) Location: Maryland (or Compact License accepted)...the flexibility to choose between a 36 or 48-hour contract , with a requirement to work every other weekend.… more
    Upward (08/12/25)
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  • Managed Care Contract Support…

    Publix (Lakeland, FL)
    **34227BR** **Position Title:** Managed Care Contract Support Specialist **Department:** Pharmacy **Location:** Lakeland, FL **Description:** If you want ... pivotal role in the success of Publix Pharmacy and the Managed Care Contract Support Specialist serves as the subject-matter expert in the contracting… more
    Publix (08/30/25)
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  • Managed Care Compliance…

    Cedars-Sinai (CA)
    **Job Description** The Managed Care Compliance Specialist is responsible for assisting with the implementation of the internal auditing and monitoring ... contract language for Commercial, Medicare and Medi-Cal managed care . + Acts as a liaison...and beyond. **Req ID** : 11981 **Working Title** : Managed Care Compliance Specialist -… more
    Cedars-Sinai (09/11/25)
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  • Managed Care Specialist

    Devereux Advanced Behavioral Health (Orlando, FL)
    …for children, adolescents and adults whose needs are extra ordinary. As a Contracts / Managed Care Specialist , you will: + Distribute monthly rosters to ... **Description** _Are you a Contracts and Managed Care Professional looking for a...and conduct audit reviews for MMAs. + Coordinate with contract representatives and network providers to resolve claims issues.… more
    Devereux Advanced Behavioral Health (09/05/25)
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  • Contract Specialist Lead

    Corewell Health (Grand Rapids, MI)
    …internal and external customers. The successful candidate will understand the nuances of managed care contracting, analytics, managed care payers, ... Operating Committee meetings. May be requested to present and represent Managed Care Contracting updates/initiatives at meeting with internal/external… more
    Corewell Health (06/19/25)
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  • Contract Specialist

    Gentiva (Atlanta, GA)
    **Overview** We're looking for a ** Contract Specialist ** to join our team.You will report directly to the VP of Regulatory Counsel andbe responsible for ... preparing, reviewing, analyzing, and responding to requests for managed care , provider, and other related healthcare agreements. + Prepares and negotiates… more
    Gentiva (08/15/25)
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  • ( Contract ) Patient Resource…

    Genentech (South San Francisco, CA)
    …degree is required. + Reimbursement experience preferred with knowledge of the managed care industry. + Strong critical thinking, independent decision-making, ... job posting. In this role, applicants would be employed through Kelly, the Managed Service Provider for Genentech's Contingent Workforce, to work on a Genentech… more
    Genentech (09/06/25)
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  • Credentialing Specialist

    Robert Half Office Team (Palm Springs, CA)
    …credentialing and recredentialing process for healthcare providers participating in managed care networks. Verify licenses, certifications, education, training, ... (CMS), The Joint Commission (TJC), and California-specific guidelines. Knowledge of Managed Care Requirements: Maintain up-to-date understanding of managed more
    Robert Half Office Team (08/28/25)
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  • Senior Revenue Cycle Specialist

    Stony Brook University (East Setauket, NY)
    Care Hospital Revenue Cycle or Patient Accounting Department resolving hospital Managed Care payment variances and/or denials. **Job Responsibilities may ... Senior Revenue Cycle Specialist **Position Summary:** At Stony Brook Medicine, the...staff regarding departmental and unit policy and procedure, including: Managed Care Contracts. + Monitors work queues… more
    Stony Brook University (08/08/25)
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  • Credentialing Specialist

    Robert Half Office Team (Palm Springs, CA)
    …and compliance standards, with a focus on California-specific regulations and managed care requirements. This opportunity is ideal for detail-oriented ... Description We are looking for a meticulous Credentialing Specialist to join our team in Palm Springs,...initial credentialing and recredentialing processes for healthcare providers in managed care networks. * Verify licenses, certifications,… more
    Robert Half Office Team (08/30/25)
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  • Enrollment Database & Operations Specialist

    Access Dubuque (Dubuque, IA)
    …& Manufacturing, LLC Client Success & Account Manager Managed Solutions Group Managed Network Services Specialist Managed Solutions Group **Share this ... Enrollment Database & Operations Specialist **Loras College** 1 Positions ID: 9.10.25 Posted...and concisely. + Customer Oriented - ability to take care of customers' needs while following procedures. + Detail… more
    Access Dubuque (09/11/25)
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  • Housing & Community Support Specialist 1

    Spokane County (Spokane, WA)
    …the timelines established for service delivery and to meet the Washington State Health Care Authority (HCA), DOH, Managed Care Organization (MCO), and SCRBH ... Housing & Community Support Specialist 1 Print (https://www.governmentjobs.com/careers/spokanecountywa/jobs/newprint/4913284) Apply  Housing & Community Support … more
    Spokane County (07/22/25)
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  • Senior Specialist , Government Contracts

    Molina Healthcare (Rockford, IL)
    …will have the following experience-** + Live in Illinois and are familiar with Managed Care in Illinois and how HHF operates. + Background/experience in business ... Molina Healthcare is hiring a Sr Specialist in our Government Contracts department. This role...field. **Required Experience** + 3 years' experience in a managed care environment. + Experience demonstrates strong:… more
    Molina Healthcare (09/16/25)
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  • Delegation Management Specialist I

    Dignity Health (Bakersfield, CA)
    …DMHC, NCQA, CMS and other regulatory bodies preferred. - Knowledge of HIPPA, managed care environment preferred. - Strong technical proficiency in data analysis; ... care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals,… more
    Dignity Health (09/04/25)
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  • Central Authorization Specialist II

    BayCare Health System (Clearwater, FL)
    …services. Maintain proper documentation in Soarian or GE systems. Work closely with Managed Care and understands health insurances rule sets, manuals, and ... 12:00pm + **Days:** Monday - Friday This Central Authorization Specialist II opportunity is a part-time remote (following require...- 1 year of Healthcare Business Office and /or Managed Care experience + Highly Preferred -… more
    BayCare Health System (09/09/25)
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  • Account Resolution Specialist

    Prime Healthcare (Kansas City, MO)
    …, Account Resolution is the lead responsible for the timely follow-up of Managed Care /Commercial accounts. Communicates clearly and efficiently by phone with ... and reports. Responsible to obtain State collection guidelines if applicable. Reviews managed care contracts. Qualifications Education and Work Experience +… more
    Prime Healthcare (08/20/25)
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  • Account Resolution Specialist

    Prime Healthcare (Harlingen, TX)
    …, Account Resolution is the lead responsible for the timely follow-up of Managed Care /Commercial accounts. Communicates clearly and efficiently by phone with ... and reports. Responsible to obtain State collection guidelines if applicable. Reviews managed care contracts. Qualifications Education and Work Experience +… more
    Prime Healthcare (09/13/25)
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  • Account Resolution Specialist

    Prime Healthcare (Harlingen, TX)
    …, Account Resolution is the lead responsible for the timely follow-up of Managed Care /Commercial accounts. Communicates clearly and efficiently by phone with ... reports. Responsible to obtain State collection guidelines if applicable. Reviews managed care contracts. Qualifications EDUCATION, EXPERIENCE, TRAINING 1.… more
    Prime Healthcare (09/10/25)
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