- Mom's Meals (Ankeny, IA)
- …channel growth through continued development of relationships at Medicare Advantage (MA) Managed Care Plans. The position will concentrate on expanding knowledge ... Position SummaryThe Manager of Healthcare Partnerships will drive Medicare Advantage...5+ years' healthcare sales experience in areas such as managed care , long-term care , home… more
- Mom's Meals (Ankeny, IA)
- …Specialists and Supervisors handling incoming authorizations from Area Agencies on Aging, Managed Care Organizations, and Health Plans for home delivered ... Position SummaryThe Intake Manager is responsible for managing a team of...experience with a background in the health, human services, managed care , or insurance industry + Strong… more
- Cardinal Health (Des Moines, IA)
- ** Manager , Managed Care ** **What Managed Care contributes to Cardinal Health** Practice Operations Management oversees the business and ... administrative operations of a medical practice. Managed Care oversees the interactions that take place between payer and provider(s) to ensure optimal… more
- Molina Healthcare (Des Moines, IA)
- …QUALIFICATIONS:** + At least 6 years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health plan setting, ... integrity issues, and process gaps. + Applies understanding of healthcare regulations, managed care claims workflows, and provider reimbursement models to shape… more
- CVS Health (Des Moines, IA)
- …License + Certified Case Manager (CCM) + Case Management experience + Managed Care experience + Telephonic case management and/or telephonic customer service ... with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we...heart, each and every day. **Position Summary** This Case Manager RN position is 100% remote, and the employee… more
- Molina Healthcare (Des Moines, IA)
- …years of experience in a pharmacy, Medication Therapy Management (MTM), Pharmacy Benefit Manager (PBM), and/or managed care setting, or equivalent combination ... Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care . **Essential Job… more
- Molina Healthcare (Des Moines, IA)
- …* At least 8 years clinical systems experience, preferably as a product owner / manager within a managed care , nursing informatics or health care ... implementation, and oversight of technology that drives core utilization management, care management, long-term services and supports (LTSS), clinical operations and… more
- Molina Healthcare (Des Moines, IA)
- …or related **REQUIRED EXPERIENCE:** 1-3 years in case management, disease management, managed care or medical or behavioral health settings. **REQUIRED LICENSE, ... transportation. **PREFERRED EXPERIENCE:** 3-5 years in case management, disease management, managed care or medical or behavioral health settings. **PREFERRED… more
- Molina Healthcare (Des Moines, IA)
- …Nursing preferred. **Required Experience** 1-3 years in case management, disease management, managed care or medical or behavioral health settings. **Required ... in Nursing **Preferred Experience** 3-5 years in case management, disease management, managed care or medical or behavioral health settings. Preferred License,… more
- Highmark Health (Des Moines, IA)
- …consistent with established industry and corporate standards and are within the care manager 's professional discipline. + Function in accordance with applicable ... specialization + Experience in a clinical setting **Preferred** + Experience in UM/CM/QA/ Managed Care **LICENSES AND CERTIFICATIONS** **Required** + Current RN… more
- Elevance Health (West Des Moines, IA)
- …care setting preferred. + Minimum 2 years' "telephonic" Case Management experience with a Managed Care Company preferred. + Managed Care experience ... Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager Senior** is responsible for care management...Nurse Case Manager Senior** is responsible for care management within the scope of licensure for members… more
- Elevance Health (West Des Moines, IA)
- …ICU, Critical Care preferred. + Prior "telephonic" Case Management experience with a Managed Care Company preferred + Certification as a Case Manager . + ... Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager II** is responsible for performing care ...respond to emails/instant messages in a timely fashion. + Managed Care (Home Heath, Insurance, Inpatient) experience.… more
- Elevance Health (West Des Moines, IA)
- …care setting preferred. + Minimum 2 years' "telephonic" Case Management experience with a Managed Care Company preferred. + Managed Care experience ... of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with… more
- Humana (Des Moines, IA)
- …the (appropriate state) with no disciplinary action. + An active designation as a Certified Care Manager (CCM). If no active designation as a CCM at hire date, ... holistic approach for case management throughout the continuum of care . The case manager will offer guidance,...delivery system. + Knowledge of MCG or Interqual. + Managed care experience. **Additional Information** **Work Days/Hours**… more
- CDM Smith (Des Moines, IA)
- …CDM Smith currently has a new opportunity for a Senior Project Manager with previous experience managing industrial water and/or wastewater projects to join ... Smith's mission by: * Managing and serving as the lead Project Manager on water/wastewater projects * Providing technical guidance, senior leadership, and mentoring… more
- Molina Healthcare (Des Moines, IA)
- …medical facilities, healthcare vendor, commercial health insurance company, large physician practices, managed care organization, etc.) + Strong Knowledge of SQL ... **Job Summary** The Manager , Medical Economics provides support and consultation to...medical coding/billing (UB04/1500 form) + Demonstrated understanding of key managed care concepts and provider reimbursement principles… more
- Ensono (Des Moines, IA)
- …that reshape how our world runs. As an expert technology adviser and managed service provider with cross-platform certifications, Ensono empowers our clients to keep ... RELIABILITY, COLLABORATION, CURIOSITY, PASSION** At Ensono, we are reinventing managed services with our **Envision Operating System** -a software-first platform… more
- Molina Healthcare (Des Moines, IA)
- …equivalent combination of education and experience **Required Experience** * 3 years managed care experience, preferably with a national or multi-location ... **Job Description** **Job Summary** The In-Home Assessment Program Manager is part of our innovative Risk Adjustment...better support overall population heath management, reduce gaps in care and drive medical loss ratio (MLR) targets. In… more
- CVS Health (Des Moines, IA)
- …and with relevant external constituents** + **At least 3 years of experience in managed care which may include PBM, Pharma, market access, account management, ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- CVS Health (Des Moines, IA)
- …C- SNP plans. **Preferred Qualifications** Strategic thinker with knowledge of managed care , value-based models and integrated delivery systems **Education** ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
