- Abbott House (Bronx, NY)
- Job Summary: The Medicaid Managed Care Liaison is the primary contact person for the Medicaid Managed Care Plans (MMCP). MMC Liaison must ... + Medicaid Managed Care policies and procedure + The Medicaid Managed Care Liaison is a full-time position. Duties and Responsibilities: 29I… more
- AdventHealth (Maitland, FL)
- …Provides guidance and direction to PFS, Central Denials, Patient Access and Managed Care staff regarding contract terms and policies including; governmental ... key contract data elements which are populated into the Managed Care database including addition of new...ensures expeditious handling of related issues. + Support and Liaison * Supports and serves as liaison … more
- CDPHP (Latham, NY)
- …and mail. The Medicaid Special Programs Case Manager typically works in the telephonic managed care setting but may be called on to work from a variety of ... clinical experience is required. + Previous experience working with Medicaid Long Term Care Programs preferred. +...patients with social needs preferred. + Experience in home care , medical office setting, or managed health… more
- Dignity Health (Bakersfield, CA)
- …shared goals. Responsibilities include: - Collaborate with the Chief Medical Officer, Managed Care and executive leadership to develop, implement, and oversee ... Leadership to ensure consistent physician/APP interactions and experience with all internal Managed Care operations such as enrollment, claims operations and… more
- Humana (Baton Rouge, LA)
- …communication skills + 5 years of established clinical experience + Knowledge of the managed care industry including Medicare, Medicaid and or Commercial ... hospital, LTAC, Acute rehab, SNF) according to the Humana Medicaid Model of Care . *Participate in Quality...with various providers and ancillary providers. *Serve as clinical liaison with inpatient facilities and joint operating committees to… more
- Molina Healthcare (Dayton, OH)
- …integrity and other cost recovery processes + Direct PM experience in Managed Care Operations (claims, system configuration, provider data management preferred) ... and appreciates the member environments we serve + Exposure to all Managed Care industry functional departments **JOB QUALIFICATIONS** **Required Education** +… more
- Commonwealth Care Alliance (Boston, MA)
- …Bachelor's Degree or equivalent experience **Experience (Required)** + 3-5 years + Managed Care experience + Experience in health plan provider relations. ... liaison between CCA and its providers including primary care practices, specialists, physician organizations, hospitals, ancillary and LTSS...**Experience (Desired)** + Medicare/ Medicaid experience preferred. + Experience with CPT coding and… more
- Commonwealth Care Alliance (Boston, MA)
- …+ Strong claims experience + Mentoring subject matter expert of the team + Managed Care experience (preferably Medicare/ Medicaid ) + Experience in health plan ... for building, maintaining and strengthening relationships with the Commonwealth Care Alliance's (CCA) diverse provider community - including physician, hospital,… more
- AmeriHealth Caritas (Charleston, SC)
- …configuration process/systems and its relevance/impact on network operations. + 1 to 2 years managed care or related experience preferred. + 1 to 2 years ... care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral… more
- Molina Healthcare (MI)
- …**Required Experience:** + 3-5 years' experience in healthcare industry, preferably in the Medicaid Managed Care Programs + Previous healthcare marketing ... Molina Healthcare of Michigan is hiring a Tribal Liaison . Candidates must reside in Michigan. There will...locality with reliable transportation. **Preferred Experience:** Experience in the Medicaid Managed Care Programs Experience… more
- Molina Healthcare (Racine, WI)
- …with Medicaid contract analytics is highly preferred. + Experience working on Managed care analytics and healthcare reimbursement models is required. + Must ... Financial and Utilization Metrics of Healthcare. + Must be able to act as a liaison between Finance and Network Contracting as well as other external teams. + Must… more
- Allaire Rehab & Nursing (Freehold, NJ)
- …+ Maintain a working knowledge of Federal and State regulations and reimbursement ( Managed Care , Medicare, and Medicaid ). + Provide assistance with ... Allaire Health Services is looking for a Marketing Liaison to join our incredible New Jersey team!...admissions process. + Maintain a strong working knowledge of managed care referral processes. + New Jersey… more
- CVS Health (Richmond, VA)
- …outcomes, a strong clinical consultant + 2+ years experience required working for a managed care organization (MCO). + Med Compass experience a Plus **Education ... any additional reasonable requirements set by the Leader or Company. The BH Clinical Liaison is a clinical leader in the Medicaid plan focusing on utilization… more
- Novant Health (Charlotte, NC)
- …years' experience in home care or hospice, required. + Previous experience in managed care , infusion care , and case management and previous home ... What We Offer Hospice Liaison Nurse - Full-Time, Days Charlotte Hospice -...dignity, quality, and comfort at every step of the care journey. In this meaningful role, you'll clinically assess… more
- Elevance Health (Columbus, OH)
- …Detail-oriented with excellent organizational skills is highly preferred. + Experience working in managed care with Medicaid Plan implementation is highly ... **Program Coordinator, State Liaison ** **Location:** Ohio **Hybrid 1:** This role requires...granted as required by law. The **Program Coordinator, State Liaison ** manages the development, approval, implementation and compliance of… more
- MyFlorida (Tallahassee, FL)
- …etc.) The incumbent conducts program training and provides technical assistance related to Medicaid managed care programs, including contracted Medicaid ... Medicaid program, including pertinent federal regulations, state statutes, administrative rules, Florida Medicaid State Plan, managed care waivers, and … more
- Somatus (Falls Church, VA)
- …including Group Health Plans (GHPs), Medicare, Medicaid , and managed care plans. Serve as a liaison between patients, insurance companies, and the ... Overview As the largest and leading value-based kidney care company, Somatus is empowering patients across the country living with chronic kidney disease to… more
- CVS Health (Springfield, IL)
- …And we do it all with heart, each and every day. Aetna Better Health is Aetna's Medicaid managed care plan. Backed by over 30 years of experience managing ... seeking an experienced leader with deep operational expertise in Medicaid Managed Care to serve...Network Development to build provider networks. + Serve as liaison with regulatory agencies and communicate updates to leadership.… more
- MyFlorida (Tallahassee, FL)
- …Medicaid 's managed care programs, with a focus on the Statewide Medicaid Managed Care (SMMC) program and Dual Eligible Special Needs (D-SNP) ... to be the most cost-effective, transparent, and high-quality health care system in the nation The Medicaid ...The bureau's primary responsibility is to ensure that the managed care plans meet contractual requirements, including… more
- Stony Brook University (Stony Brook, NY)
- …all potential medical interventions. + Demonstrates an understanding of managed care trends, payer regulations and Medicare/ Medicaid criteria for services. ... medical supplies and equipment. + Serves as an office liaison to outside nurses for patients on home telemonitoring....Experience in Care Management + Experience in Managed Care /Insurance Industry/MD Office. + Certified in… more