- Elevance Health (Neillsville, WI)
- …is granted as required by law._ Anthem is very excited to be a managed care organization in western/southwestern Wisconsin and Milwaukee County to offer the ... rounds to support development of a fully integrated care plan , engaging the member's circle of...federal requirements. Anthem is very excited to be a managed care organization in western/southwestern Wisconsin and… more
- Humana (Madison, WI)
- …+ Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization + Knowledge of Medical Terminology and/or ICD-10 ... codes + Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization + Bilingual (English & Spanish) fluent in… more
- Humana (Madison, WI)
- …+ Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization + Proficient utilizing electronic medical record ... caring community and help us put health first** The UM Administration Coordinator contributes to administration of utilization management. The UM Administration … more
- Highmark Health (Madison, WI)
- …degree + Pharmacy technician certification certificate + Experience working in a managed care medication formulary management environment + Working knowledge of ... reviewer in monitoring and ensuring adherence to the health plan 's state and federal multiple drug benefit design offerings....to ensure that the needs of the provider and plan member are addressed in a courteous, helpful and… more
- Elevance Health (Richland Center, WI)
- …is granted as required by law._ Anthem is very excited to be a managed care organization in western/southwestern Wisconsin and Milwaukee County to offer the ... **LTSS Service Coordinator - RN Clinician (RN Case Manager)** **Hiring...of licensure, develops, monitors, evaluates, and revises the member's care plan to meet the member's needs,… more
- Option Care Health (Madison, WI)
- …IG to include clinical, market, and payer dynamics + Knowledge of reimbursement, managed care , and marketing **Basic Qualifications** + Proven record of ... clinicians as well as medical office staff (ie biologics coordinator ) to appropriately promote Option Care Health...Maintain a call average as outlined in the sales plan , defined as face-to-face interactions with healthcare providers, focusing… more
- CVS Health (Madison, WI)
- …clinical case management or crisis intervention as appropriate. - Coordinates and implements assigned care plan activities and monitors care plan ... **Preferred Qualifications** - Case Management and discharge planning experience. - Managed Care experience. **Education** Bachelor's degree or non-licensed… more
- Walworth County (Elkhorn, WI)
- …following tax-sheltered benefits: Deferred Compensation (S457 plan ) Medical Spending Account (S125 plan ) Dependent Care Plan (S125 plan ) Health ... individual students is privileged and confidential and correspondingly must be managed with extreme care . Certifications, Licenses, Registrations Wisconsin… more
- Humana (Reedsburg, WI)
- …and preferences, focusing on health and safety needs to develop a comprehensive Member Care Plan (MCP). + Coordinate services that address members' health and ... case notes, service authorizations, and updates to the Member Care Plan . + Foster direct collaboration with...and inclusive communities, Inclusa deploys a unique approach to managed care with a trademarked model of… more