- Cardinal Health (Madison, WI)
- ** 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 (Madison, WI)
- …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 (Madison, WI)
- …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
- Molina Healthcare (Madison, WI)
- …* 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 (Sun Prairie, WI)
- …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
- Molina Healthcare (Madison, WI)
- …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
- Gentiva (Madison, WI)
- …to grow and flourish, and full benefit package. **As a Senior Hospice RN Patient Care Manager , you will:** + Lead and support hospice patient care ... experience + Knowledge of hospice principles, regulatory compliance, and managed care + Strong communication, collaboration, and...+ We maintain a drug-free workplace Keywords: hospice RN manager , patient care manager senior,… more
- Highmark Health (Madison, WI)
- …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
- Humana (Madison, WI)
- …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
- CDM Smith (Madison, WI)
- …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 (Madison, WI)
- …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
- CVS Health (Madison, WI)
- …utilizing and navigating multiple software programs concurrently. **Preferred Qualifications** - Managed care experience -Advanced training (ie, Board-certified ... requests pharmacist attendance for an onsite visit/assessment/audit. The Pharmacy Program Manager role includes: -Collaborate with an interdisciplinary care … more
- St Croix Hospice (Middleton, WI)
- …The Manager of Clinical Services is responsible for ensuring that patient care is coordinated and managed appropriately. This position is responsible for ... Manager of Clinical Services Job Details Level Management Job Location...ensuring that care and services are delivered appropriately and for the supervision of… more
- CVS Health (Madison, WI)
- …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 (Madison, WI)
- …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
- Pacific Northwest National Laboratory (Madison, WI)
- …and opportunities of tomorrow. **Responsibilities** As a Senior Digital Project Manager , you are involved in leading strategic initiatives for the laboratory ... and oversee the quality of deliverables and products. The Senior Digital Project Manager takes a holistic project approach by collaborating with users, business, and… more
- UMB Bank (Madison, WI)
- 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
- Humana (Madison, WI)
- …the State of Wisconsin or be eligible for Certification and Licensure. + Previous managed care experience. + General knowledge of Medicaid and Medicare benefits. ... help us put health first** Humana/iCare is seeking a Care Coach to join the growing Dane County team...join the growing Dane County team in the Family Care Partnership (FCP) program. The FCP Care … more
- Molina Healthcare (Madison, WI)
- …: * 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
- Molina Healthcare (Madison, WI)
- …EXPERIENCE** : * 5-7 years of Program and/or Project management experience. * Managed Care experience. * Experience working in a cross functional highly ... DESCRIPTION** **Job Summary** This position is the product owner for the Care Mangement system. Responsible for internal business projects and programs involving… more