- Northeast Georgia Health System, Inc (Gainesville, GA)
- …DegreeMinimum Experience: Minimum two (2) years credentialing experience in a managed care organization, hospital or physician environment. Proficient in ... processes are completed following departmental procedure and include enrollment in HP contracts .On an ongoing basis, tracks timeliness of provider loads by payer to… more
- Robert Half Accountemps (Van Nuys, CA)
- Description We are offering a long-term contract employment opportunity for a Managed Care Coordinator in the healthcare industry. Based in Van Nuys, ... Operating Committee (JOC) meetings to discuss and strategize on managed care issues. * Conduct contract...Demonstrable experience in negotiating and managing care contracts * In-depth knowledge of Medicaid managed … more
- ManpowerGroup (Columbia, SC)
- **Title:** ** Managed Care Coordinator UM II** **Location: Columbia SC (Onsite)** **Duration: 3 months** **Pay Range : $31/hr (On W2)** We are looking for a " ... ** Managed Care Coordinator UM II**...information to support and determine medical necessity criteria and contract benefits. + Collaborates with Care Management… more
- ManpowerGroup (Columbia, SC)
- **Title: Coordinator , Managed Care I** **Location: Columbia SC** **Duration: 06 Month's Contract ** **Pay Range $25.00 to $31.00/hr.** We are looking for ... a " Coordinator , Managed Care I" to...information to support and determine medical necessity criteria and contract benefits. + 20% Utilizes allocated resources to back… more
- Fresenius Medical Center (Franklin, TN)
- …coordination, and administration of contracting and pricing procedures. This includes contract terms and conditions, products and prices for various market segments ... supporting analysis, documentation and reports + to support negotiations of contract terms and department administration. + Maintains complete, accurate, and… more
- Queen's Health System (Honolulu, HI)
- … contracts , financial analysis methods, accounting principles, and health care delivery systems. o Knowledge of requirements specific to government-funded health ... RESPONSIBILITIES I. JOB SUMMARY/RESPONSIBILITIES: * Coordinates and administers contracts with healthcare insurance providers for The Queen's...to make recommendations to maximize cost and quality of care . * Serves as a liaison with third party… more
- US Tech Solutions (Columbia, SC)
- …plan, implement, health coach, coordinate, monitor, and evaluate medical necessity and/or care plan compliance, options, and services required to support members in ... of clinical information to support and determine medical necessity criteria and contract benefits. + Utilizes allocated resources to back up review determinations.… more
- Immigration and Customs Enforcement (Conroe, TX)
- …Managers, BH Medical Assets Support Team), and other IHSC personnel (ie, Field Medical Coordinator , Managed Care Coordinator , etc.), other health ... civil servants, and contract staff. The IHSC provides on-site direct patient care to ICE detainees at 20 detention facilities throughout the country and manages… more
- AdventHealth (Maitland, FL)
- …adjudication. Provides guidance and direction to PFS, Central Denials, Patient Access and Managed Care staff regarding contract terms and policies including ... performance and allows AdventHealth the ability to accurately model contracts for future negotiations. The accuracy of these builds...contract data elements which are populated into the Managed Care database including addition of new… more
- Prime Healthcare (Ontario, CA)
- …Knowledge of physician credentialing process, and strong follow-up skills.3. Knowledge of Managed Care contracts and the contracting process.4. Working ... for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf Responsibilities The Contracts Coordinator will work with the Contract Analyst… more
- Sharp Electronics Corporation (Indianapolis, IN)
- …is responsible for the timely and accurate creation and processing of contract billing, in compliance with all Sharp Electronics policies and procedures. ... **Responsibilities** + Ensure completeness and accuracy of maintenance contract documents including MICAS (meter automation) requirements and valid account contacts… more
- AdventHealth (Maitland, FL)
- …or limitations of the contract management systems as they relate to building managed care government and state contracts . * Articulates escalated issues ... after identifying and quantifying the issue. * Supports the Managed Care Contract Administration, AH...and participates in applicable Epic forums related to Epic Contracts and Managed Care and… more
- Spokane County (Spokane, WA)
- Integrated Care Coordinator Print (https://www.governmentjobs.com/careers/spokanecountywa/jobs/newprint/4657899) Apply Integrated Care Coordinator ... associated program goals and objectives. There are three Integrated Care Coordinator areas of assignment within CSD:...individual, family, and group counseling. + Practices standards for managed care as it applies to clinical… more
- AbbVie (North Chicago, IL)
- …lives across several key therapeutic areas - immunology, oncology, neuroscience, and eye care - and products and services in our Allergan Aesthetics portfolio. For ... impact program timelines. + Draft and execute all CCG managed agreements for US and Global Waiver countries, +...are met. + Provide support to consultants related to contract review, requests for revisions, and execution including follow-up… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Registered Nurse Care Coordinator , Chronic Care Management Full time, 80 hours per pay period, Day shift Remote work, equipment provided, some ... by educating the patient/families and coordinating additional services needed. The RN Care Coordinator works in collaboration with and provides guidance to… more
- HCA Healthcare (Austin, TX)
- … care management/coordination, or other related field + Managed care understanding regarding value-based payer contract requirements + Great communication ... integrity. We care like family! Jump-start your career as a(an) Clinical Care Coordinator today with St Davids Care Partners. **Benefits** St Davids … more
- State of Colorado (Denver, CO)
- Youth Corrections Medical Operations Coordinator (Nurse V) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4573875) Apply Youth Corrections ... Medical Operations Coordinator (Nurse V) Salary $108,540.00 - $151,968.00 Annually Location...is the agency statutorily mandated to provide for the care and supervision of youth committed by the District… more
- Sharp HealthCare (San Diego, CA)
- …of available community resources and current standards of clinical practice. + Knowledge of managed care and Health Plan contracts . + Understanding of the ... as a case manager or discharge planner interacting with managed care payers. + Experience with InterQual...+ Act as a resourceDemonstrates knowledge of Health Plan contracts and Health Plan benefits Coordinates services and supplies… more
- Banner Health (Phoenix, AZ)
- …Educates other health care providers, payors and patients on concepts of managed care , managed care networks, transplant networks, individual ... **Department Name:** Pre-Kidney Trans-Hosp **Work Shift:** Day **Job Category:** Clinical Care Great options and great opportunities. Banner Health has both the… more
- AmeriHealth Caritas (Raleigh, NC)
- … care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral ... ** Coordinator Provider Network** Location: Raleigh, NC Primary Job...member, provider and/or finance operations in a healthcare or Managed Care Organization + 1-2 years' experience… more
