- 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
- Publix (Lakeland, FL)
- … Care Contract Support Specialist serves as the subject-matter expert in the contracting process for the Managed Care Contracting Team in the ... **34227BR** **Position Title:** Managed Care Contract Support Specialist...The Managed Care Contract Support Specialist is responsible for optimizing the contracting … more
- Corewell Health (Grand Rapids, MI)
- …complex internal and external customers. The successful candidate will understand the nuances of managed care contracting , analytics, managed care ... Committee meetings. May be requested to present and represent Managed Care Contracting updates/initiatives at meeting with internal/external constituencies.… more
- Molina Healthcare (Cincinnati, OH)
- …in the health care field including, but not limited to, provider's office, managed care organization, or other health care field. **PREFERRED EDUCATION** ... or an equivalent combination of education and experience **PREFERRED EXPERIENCE** : 1-3 Years Managed Care experience To all current Molina employees: If you are… more
- Stony Brook University (East Setauket, NY)
- …and denied accounts. + Collaborates on denials prevention initiatives. + Liaises with Managed Care Contracting and Insurance Company Provider Representatives ... Senior Revenue Cycle Specialist **Position Summary:** At Stony Brook Medicine, the...Hospital Revenue Cycle or Patient Accounting Department resolving hospital Managed Care payment variances and/or denials. **Job… more
- Houston Methodist (Sugar Land, TX)
- …+ Maintains knowledge of Federal, State, and local billing regulations and partners with managed care contracting as needed. + Maintains knowledge of ... determinations and, denial reason and trending as appropriate, Monitors CMS, managed care and payor communications for updates/alerts/releases and functions… more
- Penn Medicine (Plainsboro, NJ)
- …significant knowledge of all types in-network and out-of-network health insurance, managed care companies, benefits and policies for commercial, Medicare ... you living your life's work? **Job:** Full Time Verification Specialist **Location:** PMPH Specialist Staff - Medical...+ Ability to develop a good working relationship with managed care organizations, and provide excellent customer… more
- Waystar (Atlanta, GA)
- …Develop and maintain strong relationships with payers, including health insurance companies, managed care organizations, and government agencies. + Create new, ... **ABOUT THIS POSITION** The Payer Relations Specialist is responsible for initiatives to identify and...performance. + Track and communicate the status of payer contracting and connections activities **OPTIONAL DETAILS --Looking for… more
- 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
- Carnival Cruise Line (Miami, FL)
- …Effectively coordinate and collaborate with stakeholders to ensure ownership and contracting is deliberately/consciously managed and applied. + Measuring and ... something for everyone. We are looking for an amazing Specialist , Training Governance to fill this role, which is...targets are met and that corporate reporting requirements are managed . + Responsible for all governance group preparation and… more
- Gentiva (Atlanta, GA)
- …andbe responsible for preparing, reviewing, analyzing, and responding to requests for managed care , provider, and other related healthcare agreements. + Prepares ... **Overview** We're looking for a **Contract Specialist ** to join our team.You will report directly...and negotiates agreements with contracting agencies/payors. + Consults frequently with operations in the… more
- Sharp HealthCare (San Diego, CA)
- …the system. **Required Qualifications** + 3 Years experience in a hospital, ambulatory care and/or managed care pharmacy environment. + California Pharmacist ... Pharmacy -REQUIRED **Preferred Qualifications** + 3 Years experience with managed care , PBM and/or Medicare Part D,...to drug reimbursement and net revenue, across all ambulatory care settings.Assists Contract's team with DOFR contracting … more
- Cedars-Sinai (CA)
- …a dynamic, inclusive environment that fuels innovation and the gold standard of patient care we strive for. **What will you be doing:** The Sales Outreach ... Specialist is responsible for successfully promoting the use of...and provides strong customer service resulting in increased specialty care referrals to Cedars-Sinai Medical Center (CSMC). The incumbent… more
- UHS (Binghamton, NY)
- …healthcare system, one connection at a time. Primary Department, Division, or Unit: UHS Managed Care Contracting Primary Work Shift: Day Regular Scheduled ... (UHS) is seeking a proactive and analytical Clinical Denials Specialist to join our Revenue Cycle team. In this...clinical staff to prevent future issues, and ensuring that care delivered is care reimbursed. Join us… more
- Compass Group, North America (Charlotte, NC)
- …the world's largest contract food and support services provider. **Why Foodbuy?** We care about our associates, our clients, and our community. We think big, ... clients, business partners and fellow associates. **Job Summary** The **Procurement Specialist ** role sits in out our Termset Management, Operations Department and… more
- Veterans Affairs, Veterans Health Administration (Temple, TX)
- Summary This position serves as an Operating Room Inventory Manager Specialist in the Commodity Management Division with specialized focus on the Medical/Surgical ... of the Logistics Service in a Veteran Affairs Health Care System (VA HCS) and supported catchment area, with...to all surgery service, prosthetics, nursing and SPS. Inventories managed include a wide variety of OR expendable items… more
- Helio Health Inc. (Syracuse, NY)
- …Guidelines. + Coordinates services with external case managers, managed care operators, licensing, funding, and contracting agencies. + Provide excellent ... support the mission of Helio Health, Inc., theFinancial Management Unit Specialist (Representative Payee) is responsible for the day-to-day interaction with patients… more
- Molina Healthcare (Cleveland, OH)
- …or equivalent combination of education and experience **Required Experience** + 3-5 years managed care experience, including 2+ years in Provider Claims and/or ... level (or higher) **Preferred Education** Bachelor's Degree **Preferred Experience** + 5+ years managed care experience + QNXT; SQL experience + Crystal Reports… more
- Queen's Health System (Honolulu, HI)
- …Microsoft Office applications (ie Outlook, Word, Excel, PowerPoint). * Knowledge of managed care and healthcare operations preferred. * Prior experience working ... and purchasers (value base contracting ) preferred. * Prior project management experience in health care preferred. Equal Opportunity Employer/Disability/Vet more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …required. Qualifications: + Minimum of two (2) years previous experience in a managed care organization's Credentialing department. + NAMSS CPCS certification is ... for completeness and requesting missing data from the practitioner offices and/or Contracting Department staff; + Creating a new electronic record in the… more
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