- Humana (Sacramento, CA)
- …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... experience, and judgement to make determinations whether requested services, level of care , and/or site of service should be authorized. All work occurs within… more
- Humana (Sacramento, CA)
- …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... + MD or DO degree + 5+ years of direct clinical patient care experience post residency or fellowship, which preferably includes some experience in an… more
- UCLA Health (Los Angeles, CA)
- …related field required + Minimum of five years' experience in a Medicare or Managed Care environment managing enrollment, claims or encounters required + Minimum ... data analysis and reporting to support operational decisions + Lead and support audits, quality control initiatives, and performance...years' experience with CMS processes in a Medicare or Managed Care environment required + Experience with… more
- J&J Family of Companies (San Francisco, CA)
- …to address critical access and affordability issues for patients. . Partner with managed care colleagues to understand current policies and potential future ... (FRM) is responsible for serving as the primary field-based lead for education, assistance, and issue resolution with healthcare...across multiple payer types and plans (ie, Medicare, Medicaid Managed Care , Commercial). . Execute business in… more
- UCLA Health (Los Angeles, CA)
- …field required + Minimum of five (5) years' experience in a Medicare or Managed Care environment managing enrollment, claims or encounters required + Minimum of ... years' experience with CMS processes in a Medicare or Managed Care environment required + Experience with...and systems to improve efficiency. + Proven skills to lead and facilitate cross-functional workgroups and other meetings. +… more
- The County of Los Angeles (Los Angeles, CA)
- …+ Direct payor contracting strategy: negotiate and manage contracts with managed care organizations and third-party payors to optimize reimbursement, ... homelessness and/or Medicaid/Medi-Cal initiatives. + Extensive experience working with Medi-Cal Managed Care Plans. + Extensive experience managing large-scale… more
- J&J Family of Companies (Sacramento, CA)
- …to address critical access and affordability issues for patients + Partner with managed care colleagues to understand current policies and potential future ... (FRM) is responsible for serving as the primary field-based lead for education, assistance, and issue resolution with healthcare...across multiple payer types and plans (ie, Medicare, Medicaid Managed Care , Commercial). + Execute business in… more
- Humana (Sacramento, CA)
- …+ Advanced Degree (such as MSN, MBA, MHA, MPH). + Experience in managed care , health plan operations, or Medicare Advantage programs (including various ... part of our caring community and help us put health first** **Clinical Business Lead , Humana Medicare Advantage** As Regional Clinical Business Lead , you serve… more
- Abbott (Los Angeles, CA)
- …opportunity in the Abbott Diabetes Care Division. We are helping people with Diabetes lead healthier, happier lives. As a global leader in diabetes care , ... Abbott is a global healthcare leader that helps people live more fully at...sales quotas/objectives for ADC Products. Collaborate with various channels, Managed Care and Retail and Point of… more
- Prime Healthcare (Lynwood, CA)
- …Resolution is the lead responsible for the timely follow-up of Managed Care /Commercial accounts. Communicates clearly and efficiently by phone with health ... and reports. Responsible to obtain State collection guidelines if applicable. Reviews managed care contracts. Qualifications + Minimum of four years hospital… more