- BoldAge PACE (Cromwell, KY)
- … or community based setting.3 years progressive management experience required.Experience in home care , managed care , or long-term care ... home with grace and dignity? BoldAge PACE is an all-inclusive program of care , personalized to meet the individual health and well-being needs of our participants.… more
- Cardinal Health (Frankfort, KY)
- …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 (Covington, KY)
- …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 (Owensboro, KY)
- …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 (Louisville, KY)
- …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 (KY)
- …* 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 (KY)
- …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 (Louisville, KY)
- …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 (Owensboro, KY)
- …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
- Option Care Health (Lexington, KY)
- …Option Care . Description of available services is accurate. Meets with managed care organizations and other accounts to facilitate education regarding ... no limit to the growth of your career.** Option Care Health, Inc. is the largest independent home and...brightest talent in healthcare. **Job Description Summary:** The Pharmacy Manager is a licensed professional who is responsible for… more
- Humana (Frankfort, KY)
- …+ 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 (Owensboro, KY)
- …(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
- CVS Health (Frankfort, KY)
- …model preferred. + Discharge Planning Experience. + Motivational Interviewing skills + Managed Care /Utilization Review Experience + Bilingual preferred. + BSN ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- Humana (Frankfort, KY)
- …help us put health first** Humana Healthy Horizons in Kentucky is seeking a Field Care Manager , Behavioral Health 2 who will assess and evaluate member's needs ... care and wellbeing of members. The Field Care Manager , Behavioral Health 2 work assignments...Illness (SPMI) and/or Substance Abuse Disorder (SUD) patients + Managed Care Experience + Case Management Certification… more
- CDM Smith (Louisville, KY)
- …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
- Elevance Health (Louisville, KY)
- …preferred. + BS in a health or human services related field is preferred. + Managed Care experience is preferred. Please be advised that Elevance Health only ... ** Manager II Case Management** **Sign on Bonus: $5000**...Management** is responsible for managing a team of nurse care managers engaged in assessing, developing, implementing, coordinating, monitoring,… more
- CAI (Frankfort, KY)
- 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
- Amgen (Louisville, KY)
- …stakeholders on disease state awareness and product information to support optimal patient care . As a SAM, you will drive product utilization while identifying and ... strong relationships with a range of stakeholders across the patient care ecosystem-including physicians, nurses, office staff, case managers, infusion centers, and… more
- Molina Healthcare (Owensboro, KY)
- …in health care field including, but not limited to, provider's office, managed care , or other health care field. **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS ... with leadership based on feedback rom assigned MHI attorney. * Assists Manager and/or Director in the negotiation of medical group/IPA and hospital contracting.… more
- Molina Healthcare (Covington, KY)
- …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
