- Cardinal Health (Boise, ID)
- ** Manager , Managed Care ** **What Managed Care contributes to Cardinal Health** Practice Operations Management oversees the business and ... administrative operations of a medical practice. Managed Care oversees the interactions that take place between payer and provider(s) to ensure optimal… more
- Molina Healthcare (Meridian, 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
- CVS Health (Boise, ID)
- …License * Certified Case Manager (CCM) * Case Management experience * Managed Care experience * Telephonic case management and/or telephonic customer service ... with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we...heart, each and every day. **Position Summary** This Case Manager RN position is 100% remote, and the employee… more
- Molina Healthcare (Meridian, 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
- Highmark Health (Boise, ID)
- …consistent with established industry and corporate standards and are within the care manager 's professional discipline. + Function in accordance with applicable ... specialization + Experience in a clinical setting **Preferred** + Experience in UM/CM/QA/ Managed Care **LICENSES AND CERTIFICATIONS** **Required** + Current RN… more
- Molina Healthcare (Boise, 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 (Meridian, 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
- Humana (Boise, ID)
- …the (appropriate state) with no disciplinary action. + An active designation as a Certified Care Manager (CCM). If no active designation as a CCM at hire date, ... holistic approach for case management throughout the continuum of care . The case manager will offer guidance,...delivery system. + Knowledge of MCG or Interqual. + Managed care experience. **Additional Information** **Work Days/Hours**… more
- Molina Healthcare (Meridian, 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 (Meridian, 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
- Molina Healthcare (Meridian, ID)
- …medical facilities, healthcare vendor, commercial health insurance company, large physician practices, managed care organization, etc.) + Strong Knowledge of SQL ... **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
- Ensono (Boise, ID)
- …that reshape how our world runs. As an expert technology adviser and managed service provider with cross-platform certifications, Ensono empowers our clients to keep ... RELIABILITY, COLLABORATION, CURIOSITY, PASSION** At Ensono, we are reinventing managed services with our **Envision Operating System** -a software-first platform… more
- Magellan Health Services (Boise, ID)
- …Other Job Requirements Responsibilities 5 years post degree experience in a direct care clinical setting; managed care experience preferred. 1 year ... and/or nonclinical management staff, including utilization management and intensive care management staff, providing expertise in designated programs. + Assists… more
- Molina Healthcare (Meridian, ID)
- …equivalent combination of education and experience **Required Experience** * 3 years managed care experience, preferably with a national or multi-location ... **Job Description** **Job Summary** The In-Home Assessment Program Manager is part of our innovative Risk Adjustment...better support overall population heath management, reduce gaps in care and drive medical loss ratio (MLR) targets. In… more
- St. Luke's Health System (Meridian, ID)
- …collaboration, and prioritizes employee well-being. Our commitment to excellence in patient care extends to creating an environment where our team can thrive both ... great place to work. We are seeking a Sourcing Manager 3 to join our Supply Chain Team. The...facilitate successful negotiation and closure of contracts with suppliers managed . + Leads supplier management process, including supplier development… more
- CVS Health (Boise, ID)
- …and with relevant external constituents** + **At least 3 years of experience in managed care which may include PBM, Pharma, market access, account management, ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- CVS Health (Boise, ID)
- …C- SNP plans. **Preferred Qualifications** Strategic thinker with knowledge of managed care , value-based models and integrated delivery systems **Education** ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- UMB Bank (Boise, ID)
- As the **Portfolio Manager - BBBLC** **,** you will be responsible for assisting Business Banking and Practice Finance officers in the portfolio management ... activities (generally loans over $500,000) that are reviewed, decisioned and managed by the BBLC (Business Banking Loan Center). You will partner with and support… more
- Molina Healthcare (Meridian, ID)
- …: * 5-7 years of Medicare Stars Program and/or Project management experience. * Managed Care experience. * Experience working in a cross functional highly ... **Job Description** **Job Summary** Molina Medicare Stars Program Manager functions oversees, plans and implements new and existing health care quality… more