- Elevance Health (Woodbridge, VA)
- ** Managed Care Coordinator ** **Location:** The candidate should be located in Spotsylvania or Fredericksburg, VA. **Field** : This field-based role enables ... employment, unless an accommodation is granted as required by law._ The ** Managed Care Coordinator ** is responsible for overall management of member's… more
- Erickson Living (Springfield, VA)
- …Greenspring Village by Erickson Senior Living Join our team as the MDS Coordinator is responsible for the coordination of the entire Resident Assessment Instrument ... to both the MDS analysis vendor and CMS. MDS Coordinator is also responsible for providing education on the...+ Onsite medical centers, providing wellness visits and sick care for all team members over 18 years of… more
- Humana (Washington, DC)
- …+ Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization + Proficient utilizing electronic medical record ... caring community and help us put health first** The UM Administration Coordinator contributes to administration of utilization management. The UM Administration … more
- Humana (Washington, DC)
- …+ Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization + Knowledge of Medical Terminology and/or ICD-10 ... codes + Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization + Bilingual (English & Spanish) fluent in… more
- Cardinal Health (Washington, DC)
- …management preferred. + Familiarity with Medicare, Medicaid, commercial insurance plans, and managed care preferred. + Proficiency in billing software (eg ... Coordinator , Financial Counseling **_What Financial Assistance Counseling (RCM)...open enrollment opportunities + Initiate and track all charity care applications + Work closely with other Financial Counselors,… more
- Cardinal Health (Washington, DC)
- …management preferred. + Familiarity with Medicare, Medicaid, commercial insurance plans, and managed care preferred. + Proficiency in billing software (eg ... building relationships of trust with customers and internal business partners. The Coordinator , Collections is responsible for the timely follow-up and resolution of… more
- Cardinal Health (Washington, DC)
- …management preferred. + Familiarity with Medicare, Medicaid, commercial insurance plans, and managed care preferred. + Proficiency in billing software (eg ... and collect patient service revenue. The revenue cycle shadows the entire patient care journey and begins with patient appointment scheduling and ends when the… more
- Cardinal Health (Washington, DC)
- …Minimum 2 years of experience in Insurance follow-up preferred + Understanding of managed care contracts and fee schedules, including Medicare and Medicaid ... accurately, efficiently, promptly, recognizing their importance and relationship to patient care + Consults with appeals department for disputed / denied claims.… more
- Highmark Health (Washington, DC)
- …degree + Pharmacy technician certification certificate + Experience working in a managed care medication formulary management environment + Working knowledge of ... retail pharmacy and/or third party prescription procession + Strong background and understanding of medications and formulary terminology + Pharmacy technicians must be familiar with multiple Medicaid drug benefit design offerings and rules/regulations across… more
- Erickson Living (Springfield, VA)
- …timely manner. + Maintain current knowledge of Medicare and Medicaid coverage changes, Managed Care information, and other relevant topics for family members ... of the Health Care Sales Associate, Move-In Coordinator , Acute Care Coordinator , Marketing...We're part of a growing national network of communities managed by Erickson Senior Living, one of the country's… more
- AmeriHealth Caritas (Washington, DC)
- …and resolving problems + Coordinates care and services with the Care Coordinator , Community Health Navigator, member, member's caregiver as appropriate, PCP, ... management experience supporting Medicaid members and/or pediatric populations within a managed care organization preferred **Licensure** + Current and… more
- AmeriHealth Caritas (Washington, DC)
- …and resolving problems + Coordinates care and services with the Care Coordinator , Community Health Navigator, member, member's caregiver as appropriate, PCP, ... case management experience supporting Medicaid members and/or pediatric populations within a managed care organization preferred + 3+ years of nursing experience… more
- AmeriHealth Caritas (Washington, DC)
- …and resolving problems. + Coordinates care and services with the Care Coordinator , Community Health Navigator, and member, member caregiver as appropriate, ... Minimum of years of case management experience supporting Medicaid members within a managed care organization preferred. + Must be willing to meet face to face… more
- Erickson Living (Springfield, VA)
- …over with a company 3% match + Onsite medical centers, providing wellness visits and sick care for all team members over 18 years of age + 30% discount on food and ... the supervising clinician + Prepare reports for the Program Coordinator , and Medical Director, and Regional NP as requested...temperature log for refrigerators, documentation of all point of care and send out labs performed for each date,… more
- Erickson Living (Springfield, VA)
- …implementation, and evaluation of the delivery of safe and effective person-centered care of our 32-bed Rehab neighborhood . The Clinical Manager will also ... will make an impact + Coordinating, implementing, and overseeing the clinical care of guests/residents in skilled nursing/long-term care neighborhoods +… more
- Humana (Washington, DC)
- …health care delivery system. + Knowledge of MCG or Interqual. + Managed care experience. **Additional Information** **Work Days/Hours** : Monday - Sunday; ... holistic approach for case management throughout the continuum of care . The case manager will offer guidance, support, and...involvement. The case manager will serve as the primary coordinator and point of contact for the beneficiary for… more