- Molina Healthcare (Kearney, NE)
- …Summary** Provides subject matter expertise and leadership to healthcare services function - providing support for project/ program /process design, execution, ... into functional requirements. + Conducts quality audits to assess healthcare services staff educational needs and service quality, and implements quality… more
- Molina Healthcare (Kearney, NE)
- **Job Description** **Job Summary** The In-Home Assessment Program Manager is part of our innovative Risk Adjustment department to assist our diverse team of ... medical loss ratio (MLR) targets. In conjunction with the Manager of the In-Home Assessment Program , this...Programs, Market & Segment Leaders, health plan teams, member services , provider services , external vendors, actuary, and… more
- Molina Healthcare (Kearney, NE)
- **JOB DESCRIPTION** Job Summary: The AI Program Manager serves as a strategic leader driving the execution of AI initiatives to deliver meaningful business ... process improvement and organizational change management to operationalize the AI program vision. This includes end-to-end program planning (estimating,… more
- Molina Healthcare (Kearney, NE)
- …Responsible for creating, operating, and monitoring Molina Health Plan's pharmacy services programs in accordance with all federal and state laws. ... **Knowledge/Skills/Abilities** + Monitor the operational aspects of the Pharmacy Benefits Manager and other delegates to assure compliance with contractual and… more
- Genesis Healthcare (Kearney, NE)
- …children at home and in school. With over 38 years of trusted service , our reach spans skilled nursing centers, assisted and independent living facilities, ... + **Support for New Grads:** Our Powerback Clinical Mentorship Program kicks off on day one, helping you learn...patients and their families receive the highest quality of service in a caring and compassionate atmosphere. If this… more
- Molina Healthcare (Kearney, NE)
- …of the member's interdisciplinary care team (ICT), including referrals to state plan healthcare services . * Follows-up with members and providers to check on ... staff, and providers. * Reviews and analyzes Pharmacy Benefit Manager (PBM) reports to track general trends in drug...identify potential targeted utilization management activities. * Works with healthcare services team (eg, data managers, care… more
- Genesis Healthcare (Kearney, NE)
- …children at home and in school. With over 38 years of trusted service , our reach spans skilled nursing centers, assisted and independent living facilities, ... + **Support for New Grads:** Our Powerback Clinical Mentorship Program kicks off on day one, helping you learn...new way of delivering recovery, rehabilitation, respiratory, and wellness services to patients across the nation. We deliver an… more
- Molina Healthcare (Kearney, NE)
- **JOB DESCRIPTION** **Job Summary** Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan ... of service . **KNOWLEDGE/SKILLS/ABILITIES** + Follows member throughout a 30-day program that starts at hospital admission and continues through transitions from… more
- Molina Healthcare (Kearney, NE)
- …Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM) or Certified ... National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), state Medicaid entity requirements and all other standards and… more
- Molina Healthcare (Kearney, NE)
- …Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM), Certified ... interpretation, and appropriate level of care for provision of member services in alignment with state, federal, accrediting, and billing/coding guidelines and… more
- Molina Healthcare (Kearney, NE)
- …oversight and expertise related to behavioral health and chemical dependency services , and assists with implementation of integrated behavioral health care programs ... management and care management behavioral health programs and chemical dependency services - working closely with regional medical directors to standardize… more
- Molina Healthcare (Kearney, NE)
- …Identifies and refers members with special needs to the appropriate Molina Healthcare program per policy/protocol. **JOB QUALIFICATIONS** Graduate from an ... Certified Clinical Coder, Certified Medical Audit Specialists, Certified Case Manager , Certified Professional Healthcare Management, Certified Professional… more
- Molina Healthcare (Kearney, NE)
- …QUALIFICATIONS:** + At least 6 years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health plan setting, ... and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay Edits, Overpayment… more
- Molina Healthcare (Kearney, NE)
- …of technology that drives core utilization management, care management, long-term services and supports (LTSS), clinical operations and business processes. Considers ... least 8 years clinical systems experience, preferably as a product owner / manager within a managed care, nursing informatics or health care environment, or… more
- Walgreens (Hastings, NE)
- …to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient manner, and performs ... cash register, provides customers with courteous, fair, friendly, and efficient checkout service . + In accordance with state and federal regulations, assists the… more
- Walgreens (Kearney, NE)
- …to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient manner, and performs ... services as required; assists pharmacy staff in coordination of clinical services , Walgreens healthcare clinics and external providers. + Assists Pharmacy … more
- Rush Enterprises (Kearney, NE)
- … service truck and for keeping the vehicle properly stocked. + Report to the Service Manager and will be assigned duties on a daily basis. + Maintain ... Document and submit necessary paperwork or enter into mobile service program as work performed in an...work. Foster positive customer relations. + Advise customer and/or service writer of any repairs or services … more
- Omaha Children's Hospital (Kearney, NE)
- 4 days/ week. Occasional weekend. At Children's, the region's only full- service pediatric healthcare center, our people make us the very best for kids. Come ... Opportunities for career growth abound as we grow our services and spaces, including the cutting-edge Hubbard Center for...of the office and the direction of the office manager or physicians. * Demonstrates proficiency and use of… more
- Fresenius Medical Center (Kearney, NE)
- …procedures, and training. Supports the FMCNA's mission, vision, values, and customer service philosophy. Supports the FMCNA commitment to the Quality Enhancement ... Program (QEP) and CQI Activities, including those related to...other staff members. + Routinely meets with the Clinical Manager to discuss personnel and patient care status, issues,… more