- Cardinal Health (Boise, ID)
- …companies (ex. Blue Cross, Blue Shield, IPA, etc). Reporting to the Director of Managed Care , the Manager of Contracting is responsible for managing ... **_What Managed Care contributes to Cardinal Health_**...other activity as it relates to payer interaction. The Manager of Payor Contracting is responsible for reviewing, auditing… more
- Molina Healthcare (Boise, ID)
- …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
- Molina Healthcare (Boise, ID)
- …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
- Indeed (Boise, ID)
- …policy, and many region-specific benefits. **Benefits - Health, Work/Life Harmony, & Wellbeing** We care about what you care about. We have a multitude of ... benefits to support Indeedians, as well as their pets, kids, and partners including medical, dental, vision, disability and life insurance. Indeedians are able to enroll in our company's 401k plan, as well as an equity-based incentive program. Indeedians will… more
- Molina Healthcare (ID)
- …* 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 (Boise, ID)
- …Qualifications** * At least 3 years of experience in a pharmacy, Pharmacy Benefit Manager (PBM), formulary, and/or managed care setting, and 1-2 years ... team (ICT). * Works with the Pharmacy Benefit Manager (PBM) to manage formulary changes and update marketing...Qualifications** * Medicare Part D and/or Medicaid experience. * Managed care experience. To all current Molina… more
- Molina Healthcare (Idaho Falls, ID)
- **JOB DESCRIPTION** For this position we are seeking a Care Manager who lives in Idaho Care manager will support Idaho Medicaid. This position will have ... enrolled in this program. We are looking for a Care Manager who have experience working with...Supports. + 1-3 years in case management, disease management, managed care or medical or behavioral health… more
- Molina Healthcare (Caldwell, ID)
- …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
- Molina Healthcare (Boise, ID)
- …Long Term Services & Supports. + 1-3 years in case management, disease management, managed care or medical or behavioral health settings. + Required License, ... Degree in Nursing **Preferred Experience** + 3-5 years in case management, disease management, managed care or medical or behavioral health settings. + 1 year… more
- Humana (Boise, ID)
- …+ BSN or MSN degree + Knowledge of Milliman or Interqual + Managed care experience + Certified Case Manager (CCM) + Bilingual in English and Spanish (see ... part of our caring community and help us put health first** The Care Manager , Telephonic Nurse 2, in a telephonic environment, assesses and evaluates members'… more
- Molina Healthcare (Meridian, ID)
- …(LPN) Program **REQUIRED EXPERIENCE:** 1-3 years in case management, disease management, managed care or medical or behavioral health settings. **REQUIRED ... in OB HIGH RISK / maternal health case management, disease management, managed care or medical or behavioral health settings. To all current Molina employees:… more
- CenterWell (Boise, ID)
- …+ Experience with case management, discharge planning and patient education for adult acute care + Managed care experience + Home Health Care ... Care Coordinator is under the general supervision of the Manager of Care Coordination and under established performance criteria. This is a work-from-home… more
- Magellan Health Services (Boise, ID)
- …mental health and substance abuse benefits, community treatment resources, mental health managed care programs, and company policies and procedures, and ... + Maintains an active work load in accordance with National Care Manager performance standards. + Works with community agencies as appropriate. Proposes… more
- Molina Healthcare (Twin Falls, ID)
- …in the health care field including, but not limited to, provider's office, managed care organization, or other health care environment. * 3+ years ... Tighter knit proximity ongoing after contract. * In conjunction with Director/ Manager , Provider Contracts, negotiates Complex Provider contracts including but not… more
- Molina Healthcare (Nampa, ID)
- …or related **REQUIRED EXPERIENCE:** 1-3 years in case management, disease management, managed care or medical or behavioral health settings. **REQUIRED LICENSE, ... experience. **PREFERRED EXPERIENCE:** 3-5 years in case management, disease management, managed care or medical or behavioral health settings. **PREFERRED… more
- Molina Healthcare (Caldwell, ID)
- …Term Services & Supports. + 1-3 years in case management, disease management, managed care or medical or behavioral health settings. **PREFERRED EXPERIENCE:** + ... 3-5 years in case management, disease management, managed care or medical or behavioral health settings. + 1 year experience working with population who receive… more
- CDM Smith (Idaho Falls, ID)
- …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
- Idaho Division of Human Resources (ID)
- …over other applicants. Good knowledge of healthcare quality, reimbursement methodologies, and managed care delivery systems. Typically gained by at least three ... Program Manager - MED Posting Begin Date: 2025/10/01 Posting...+ Good knowledge of healthcare quality, reimbursement methodologies, and managed care delivery systems.Typically gained by at… more
- CAI (Boise, ID)
- Case Manager , RN **Req number:** R6346 **Employment type:** Full...+ Minimum of 3 years of experience in Acute Care , Managed Care , or experience ... **Job Summary** We are looking for a motivated Case Manager , RN ready to take us to the next...critical role in holistic assessment, planning, coordination, and monitoring care to optimize member health outcomes while advocating for… more
- Molina Healthcare (Boise, ID)
- …medical facilities, healthcare vendor, commercial health insurance company, large physician practices, managed care organization, etc.) + Strong Knowledge of SQL ... **JOB DESCRIPTION** **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