- UCLA Health (Los Angeles, CA)
- Description UCLA Health is seeking a dynamic Program Manager to support the Managed Care Operations team. This role is instrumental in overseeing the ... UAT initiatives, and participate in strategic planning related to managed care operations. Salary Range: $83,800 -...$179,400 annually Qualifications We're looking for a strong, organized program leader with: + Bachelor's degree in a related… more
- City of New York (New York, NY)
- … NM-III, to function as the Executive Director, of the Office of Mail Renewal, Managed Care Program (MCP), and Third-Party Health Insurance, who will: Under ... (MAP) divisions: the Office of Mail Renewal (OMR), the Managed Care Program (MCP), and...NY, 11238 Hours/Schedule: 9 am - 5 pm ADM MANAGER -NON-MGRL FRM M1/M2 - 1002C Qualifications 1. A baccalaureate… more
- Henry Ford Health System (Troy, MI)
- GENERAL SUMMARY: Reporting to the Director - Managed Care Contracting, this position is responsible for managing the payor contracting functions for the ... physicians of Henry Ford Health. This position is responsible for leading the Managed Care Contracting team in evaluating, analyzing, and negotiating contract… more
- Sutter Health (Goleta, CA)
- …knowledge base of health care delivery and case management within a managed care environment. + Comprehensive knowledge of Utilization Review, levels of ... RN-Registered Nurse of California + CCM - Certified Case Manager (certification may be required by entity and time...Medicare and Medicaid Services (GR) Grouper (CMS), Department of Managed Health Care , National Committee for Quality… more
- St. Luke's Health System (Boise, ID)
- …& Contracting is a key leadership role accountable for St. Luke's Health System's managed care contract portfolio, to include activities related to new contract ... As an internal expert in payer reimbursement strategies, the Manager will provide insight and guidance to internal stakeholders...internal stakeholders and the leadership team with regard to managed care contract capabilities, in alignment and… more
- Sutter Health (Goleta, CA)
- …knowledge base of health care delivery and case management within a managed care environment. Comprehensive knowledge of Utilization Review, levels of ... Coordinates the utilization management, resource management, discharge planning, post-acute care referrals and care facilitation. Oversees the management… more
- Henry Ford Health System (Troy, MI)
- …EDUCATION/EXPERIENCE REQUIRED: + Bachelor's degree in Finance, Accounting, Business Administration, Managed Care Contracting, Reimbursement, or related field. + ... GENERAL SUMMARY: Under minimal supervision of the Manager , independently leads financial and data analysis to...to seven (5-7) years of experience in healthcare finance, managed care contracting, or reimbursement in a… more
- Elevance Health (Roanoke, VA)
- ** Managed Care Coordinator** **Location:** Must reside in **Southwestern Virginia** **Hours:** Monday - Friday 8:00 am - 4:30 pm EST The ** Managed Care ... Coordinator** is responsible for performing telephonic or face-to-face history and program needs assessments using a tool with pre-defined questions for the… more
- MyFlorida (Tallahassee, FL)
- …Consultant / Managed File Transfer Administration Lead Office of FX Program Administration (FXPA) State of Florida Agency for Health Care Administration ... 68065029 - SENIOR INFO TECH BUSINESS CONSULTANT / MANAGED FILE TRANSFER ADMINISTRATION LEAD Date: Apr 21, 2025 The State Personnel System is an E-Verify employer.… more
- Hartford HealthCare (Hartford, CT)
- …**Organization:** **Hartford HealthCare Corp.* **Title:** *Sr Payer Analyst / Managed Care Contracting* **Location:** *Connecticut-Hartford-100 Pearl Street ... common practices across the system. *_Position Summary:_* Reporting directly to the Manager of Payer Contract Analytics, the Sr. Payer Analyst is responsible for… more
- Bishop McCarthy Center (Vineland, NJ)
- Employee Heath/ Managed Care / Infection Control Registered Nurse has oversight over functions of the employee health program which include pre employment ... related injury follow-up, knowledge of infection control practices. Case Manager ressponsciblitlies include gathering information to submit to insurnace companies… more
- US Tech Solutions (Columbia, SC)
- …Identifies and makes referrals to appropriate staff (Medical Director, Case Manager , Preventive Services, Subrogation, Quality of care Referrals, etc.). ... Education: Bachelor's degree- Nursing Preferred Work Experience: 7 years-healthcare program management. Preferred Licenses and Certificates: Case Manager … more
- Fortive Corporation (SC)
- …customer, you are responsible for the execution and Customer Success for their facility program . ServiceChannel Managed is a partner to our customers to oversee ... **Sr. Director Managed Services - Key Accounts** **ServiceChannel** is the...Procedures. + Vendor Management: Partnering with our Provider Development Manager assigned to your customer, you will work together… more
- US Tech Solutions (Columbia, SC)
- …+ Identifies and makes referrals to appropriate staff (Medical Director, Case Manager , Preventive Services, Subrogation, Quality of Care Referrals, etc.). ... clinical criteria to service requests or provides health management program interventions. + Utilizes clinical proficiency and claims knowledge/analysis to… more
- AdventHealth (Shawnee, KS)
- …hospital in Shawnee Mission, Kansas. **The role you'll contribute:** The Social Work Care Manager intervenes with patients who have complex psychosocial needs, ... of the care team). The Social Work Care Manager , in collaboration with the patient/family,...utilization management, care management, performance improvement and managed care reimbursement + Knowledge of state… more
- State of Massachusetts (Boston, MA)
- This Program Manager for Policy and Contracts on the Accountable Care and Behavioral Health (ACBH) Accountable Care and Policy Innovation Team will play ... MassHealth members. This role will also support broader MassHealth managed care policy development as a member...including the ACO program and Community Partners program . The Program Manager for… more
- Stanford Health Care (Palo Alto, CA)
- …social work, care coordination and discharge planning. + Knowledge of managed care and commercial insurance, Medi-Cal, Medicare, and other third-party ... work-life balance while honoring its commitment to delivering evidence-based and patient-centered care . We are seeking a results-driven manager to further… more
- Whitney Young Health Center (Albany, NY)
- …to schedule changes. Training in laboratory/phlebotomy techniques. Knowledge of managed care requirements. Bilingual. RN CARE MANAGER II:Salary range: ... Registered Nurse (RN) Care Manager (Req 100826) Albany, NY...to schedule changes. Training in laboratory/phlebotomy techniques. Knowledge of managed care requirements. Bilingual. All qualified applicants… more
- LA Care Health Plan (Los Angeles, CA)
- … Manager III is responsible for the initial on-board training of new managed care contract provider partners, and for ensuring their provider accounts ... Provider Network Account Manager III Job Category: Provider Relations Department: Provider...providing in-service orientation meetings with providers. Responsible for monitoring managed care contracts for renewals and expirations.… more
- Stanford Health Care (Palo Alto, CA)
- …social work, care coordination and discharge planning. + Knowledge of managed care and commercial insurance, MediCal, Medicare, and other third-party ... - 08 Hour (United States of America) **This is a Stanford Health Care job.** **A Brief Overview** This role independently supervises a multidisciplinary team… more