- CVS Health (Jefferson City, MO)
- …regulations. The ideal candidate should possess the following skills: + Knowledge of Behavioral Health products, benefits and offerings + Understanding of Group ... a fast-paced environment + A passion for mental and behavioral health **What You Will Do** +...MHWB's Single Point of Contact for Market conduct exams, regulatory inquiries, and objections + Support the development and… more
- CVS Health (Jefferson City, MO)
- …settlement negotiations of contracts, with large and complex, national, and market-based, behavioral health groups and facility providers. You will manage ... strategic, traditional contracts and value-based relationships. Role is for national behavioral health contracting and strategic partnerships** Key deliverables… more
- SSM Health (Jefferson City, MO)
- **It's more than a career, it's a calling.** MO-SSM Health St. Mary's Hospital - Jefferson City **Worker Type:** Regular **Job Summary:** Manages activities, ... **Job Responsibilities and Requirements:** PRIMARY RESPONSIBILITIES + Ensures compliance with regulatory and accreditation requirements for self and within unit. +… more
- Highmark Health (Jefferson City, MO)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job has primary ownership and oversight over a specified panel of members that range in ... health status/severity and clinical needs. The incumbent assesses ...and conducted in compliance with applicable business process requirements, regulatory requirements and accreditation standards. + Maintain current knowledge… more
- Highmark Health (Jefferson City, MO)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of ... appropriateness of health care services, application of criteria to ensure appropriate...industry and corporate standards and are within the care manager 's professional discipline. + Function in accordance with applicable… more
- Highmark Health (Jefferson City, MO)
- …panel. Provides oversight over a specified panel of members that range in health status/severity and clinical needs; and assesses health management needs of ... various resources to assist members in achieving their personal health goals. Will work with providers to insure quality...and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create… more
- Highmark Health (Jefferson City, MO)
- **Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding ... assignments, ICD diagnosis and procedure coding, DRG/APC structure according to regulatory requirements. Reports findings both verbally and in writing and… more