• Managed Care Organization

    State of Minnesota (St. Paul, MN)
    **Working Title: Managed Care Organization ( MCO ) Program Integrity Consultant** **Job Class: Human Services Program Representative 2** **Agency: Human ... location to be eligible for telework._** **_*Approximately 10% travel._** Minnesota's contracted Managed Care Organizations (MCOs) are required by federal rule… more
    State of Minnesota (07/12/25)
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  • Managed Care Provider Enrollment…

    Stony Brook University (Commack, NY)
    …of SBM providers for the purpose of enrolling a provider in a managed care organization or other payer (" MCO ") network. Work collaboratively with SBM ... Care checklist; Demographic data; and Participation Information. For MCO 's not under a delegated agreement: Complete enrollment applications,...moderate or significant size or on behalf of a managed care organization or payer.… more
    Stony Brook University (07/09/25)
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  • Field Care Manager, Ltss (RN) - Central…

    Molina Healthcare (Houston, TX)
    …to those candidates with previous experience working with the Medicare population within a Managed Care Organization ( MCO ). Mileage is reimbursed as ... & Supports. + 1-3 years in case management, disease management, managed care or medical or behavioral health settings. + Required License, Certification,… more
    Molina Healthcare (07/05/25)
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  • Senior LTSS Service Care Manager (RN)

    Centene Corporation (Austin, TX)
    …+ May provide guidance and support to clinical new hires/preceptees in navigating within a Managed Care Organization ( MCO ) and provides coaching and ... one person at a time. As a diversified, national organization , you'll have access to competitive benefits including a...Duty Nursing + Case Management + Service Coordination + Managed Care - STAR Kids or CHIPS… more
    Centene Corporation (07/14/25)
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  • Senior LTSS Service Care Manager (RN)

    Centene Corporation (Austin, TX)
    …+ May provide guidance and support to clinical new hires/preceptees in navigating within a Managed Care Organization ( MCO ) and provides coaching and ... one person at a time. As a diversified, national organization , you'll have access to competitive benefits including a...Teams, ZOOM, etc) are required + Experience working in managed care environment is a plus (Federal… more
    Centene Corporation (07/05/25)
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  • Senior Care Manager

    Centene Corporation (Tallahassee, FL)
    …+ Provides guidance and support to clinical new hires/preceptees in navigating within a Managed Care Organization ( MCO ) and provides coaching and ... of our communities, one person at a time. As a diversified, national organization , you'll have access to competitive benefits including a fresh perspective on… more
    Centene Corporation (07/02/25)
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  • Care Manager (RN) - Pediatrics

    Centene Corporation (Houston, TX)
    …+ May provide guidance and support to clinical new hires/preceptees in navigating within a Managed Care Organization ( MCO ) and provides coaching and ... of our communities, one person at a time. As a diversified, national organization , you'll have access to competitive benefits including a fresh perspective on… more
    Centene Corporation (07/02/25)
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  • Senior Care Manager (RN)

    Centene Corporation (New York, NY)
    …​ + Provides guidance and support to clinical new hires/preceptees in navigating within a Managed Care Organization ( MCO ) and provides coaching and ... of our communities, one person at a time. As a diversified, national organization , you'll have access to competitive benefits including a fresh perspective on… more
    Centene Corporation (06/26/25)
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  • Payment Integrity Program Manager - Health Plan

    Molina Healthcare (Dayton, OH)
    …+ At least 5 years of experience as a Business Analyst or Program Manager in a Managed Care Organization ( MCO ) or health plan setting. + Proven ... integrity issues, and process gaps. + Apply understanding of healthcare regulations, managed care claims workflows, and provider reimbursement models to shape… more
    Molina Healthcare (06/29/25)
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  • Per Diem Mental Health Counselor

    Gateway-Longview (Williamsville, NY)
    …set forth in the client's treatment plan. + In collaboration with the program supervisor/director, Managed Care Organization ( MCO ) and the child and ... Benefits Gateway Longview takes pride in offering an amazing benefits package to take care of our most important asset- our employees! We offer medical, dental and… more
    Gateway-Longview (05/30/25)
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  • Utilization Management Nurse Consultant (Remote)

    CVS Health (Carson City, NV)
    …8:30am-5:00pm EST) with 100% participation. **Preferred Qualifications** + 1+ year of experience in a managed care organization ( MCO ). + Experience in a ... management organization founded in 1993. We provide flexible, cost-effective care management solutions that promote high-quality healthcare for members. We are… more
    CVS Health (07/01/25)
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  • Housing & Community Support Specialist 1 (Open…

    Spokane County (Spokane, WA)
    …service delivery and to meet the Washington State Health Care Authority (HCA), DOH, Managed Care Organization ( MCO ), and SCRBH (ASO) standards. + ... (RSA) behavioral health agencies for individuals enrolled in primary behavioral health care services with the providers. + Provides direct behavioral health services… more
    Spokane County (04/22/25)
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  • Medicaid Managed Care Liaison

    Abbott House (Bronx, NY)
    … Liaison is a full-time position. Duties and Responsibilities: 29I Core Services Coordinate with MCO ( Managed Care Organization ) Foster Care Liaison ... Job Summary: The Medicaid Managed Care Liaison is the primary...with consent and/or confidentiality issues Obtain authorizations from all MCO Update the AccuMedic (EHR) system with the authorization… more
    Abbott House (07/04/25)
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  • RCM Specialist, Accounts Receivable

    Help at Home (Chicago, IL)
    …revenue cycle management or billing experience in the healthcare field + Knowledge of Medicaid/ Managed Care Organization ( MCO ) billing practices + ... Home is the leading national provider of in-home personal care services, where our mission is to enable individuals...change + You value _progress_ over perfection + You care about your work, the team you're on, and… more
    Help at Home (07/04/25)
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  • Behavioral Health Technician

    Sevita (Broomall, PA)
    …and experience working with children/ adolescents which varies by program and requirements of the managed care organization ( MCO ). + Licensed as required ... recommends other services. + Provide therapeutic supervision of children in our care during treatment and educational activities. + Support family and school… more
    Sevita (06/30/25)
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  • Program Manager II - MCO Quality…

    Centene Corporation (Harrisburg, PA)
    …management. + Health care experience preferred. + Previous experience with Managed Care Quality strongly preferred. + NCQA Accreditation knowledge and ... of our communities, one person at a time. As a diversified, national organization , you'll have access to competitive benefits including a fresh perspective on… more
    Centene Corporation (07/04/25)
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  • Crisis and Emergency Services System…

    CVS Health (Frankfort, KY)
    …2+ years of psychiatric experience in public sector as a practitioner or with a managed care organization + Strong foundation in understanding mental health ... stakeholders. **Preferred Qualifications** + Knowledge and understanding of the State Medicaid managed care market, regulations, practices and health care more
    CVS Health (07/11/25)
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  • Care Manager RN, Physical Health

    Humana (Columbus, OH)
    …experience + Experience with health promotion, coaching and wellness + Previous managed care experience + Bilingual - English, Spanish + Certification ... and/or a CME, or who choose to receive their care management from the MCO ). Care...clearance + Must be passionate about contributing to an organization focused on continuously improving consumer experiences **Preferred Qualifications**… more
    Humana (04/19/25)
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  • Unit Clerk

    City of New York (New York, NY)
    …as an interface between consumers, New York State Department of Health (SDOH), Managed Care Organizations ( MCO 's), clinics, hospitals, physicians groups, and ... care services at little or no cost. MAP Managed Care Client Services (MCCS) assures the...a State's department of education or a recognized accrediting organization and one year of satisfactory clerical experience. Skills… more
    City of New York (05/14/25)
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  • Referral Coordinator

    Illumination Foundation (Santa Ana, CA)
    …Referral Management & Evaluation + Review incoming referrals from hospitals, Managed Care Organizations (MCOs), Independent Physician Associations (IPAs), and ... Experience working with homeless or medically vulnerable populations + Familiarity with Managed Care Organizations (MCOs), IPAs, or hospital discharge procedures… more
    Illumination Foundation (05/23/25)
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