- Penn State Health (Hershey, PA)
- …care of a select patient population as determined by individualized plan of care , clinical pathways, managed care guidelines and contracts. Mobilizes ... family medical or genetic information._ **Union:** Non Bargained **Position** Registered Nurse Care Manager - Pediatrics Specialties - Hope Drive **Location**… more
- Catholic Health Services (Melville, NY)
- …with the Catholic Health Physician Advisor when appropriate. Reviews results from managed care payors and/or regulatory agencies determinations for further ... clinical information Acts as a resource for MCC/CM regarding regulatory or managed care requirements or regulations Meets department standards Attends meetings… more
- Molina Healthcare (Akron, OH)
- …or other health care environment. * 3+ years experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different ... Operating Committees, and delegation oversight. Tighter knit proximity ongoing after contract . * In conjunction with Director/ Manager , Provider Contracts,… more
- Elevance Health (South Portland, ME)
- …and ensures essential face-to-face onboarding and skill development. The **Behavioral Health Care Manager II** is responsible for managing psychiatric and ... broad range of experience with complex psychiatric/substance abuse cases required. + Prior managed care experience required. + For URAC accredited areas, the… more
- Dignity Health (Bakersfield, CA)
- …- Masters degree preferred. - 5 years experience with background in a managed care facility, IPA or health plan preferred. **Overview** The purpose ... care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals,… more
- Centene Corporation (Mcallen, TX)
- …Role requires strong adaptability, flexibility, and resiliency skills. + Experience working in managed care environment is a plus (Federal and State Sponsored ... 3 days per week for IN-PERSON visits with Foster Care members** **Monday - Friday 8:00 am- 5:00 pm...Licensed Behavioral Health Professional or RN based on state contract requirements eg, LCSW, LMFT, LPC, or RN with… more
- Molina Healthcare (Las Cruces, NM)
- …in health care field including, but not limited to, provider's office, managed care , or other health care field. **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS ... based on feedback rom assigned MHI attorney. * Assists Manager and/or Director in the negotiation of medical group/IPA...multispecialty provider groups. * 3+ years experience in provider contract negotiations in a managed healthcare setting… more
- Centene Corporation (Queens, NY)
- …partners **Education/Experience:** Bachelors Degree Required. MBA/MHA/MPH Preferred. 2-5 years of relevant managed care experience including at least 1 year of ... to partially offset the Education/Experience described above. 5-7 years of experience in managed care or healthcare consulting with a focus on Medicare Advantage… more
- Walgreens (Deerfield, IL)
- …+ Manages the tracking, approval, administration, and post-implementation process of all Managed Care contracts throughout the contract life cycle. ... **Job Description:** **Job Summary** The Manager of B2B Customer Success plays a critical...+ Works with Contracting Directors/Managers to review Third Party Managed Care Contracts to ensure operational requirements… more
- Molina Healthcare (Riverside, CA)
- …SKILLS & ABILITIES** : * 5-7 years experience in Healthcare Administration, Managed Care , Provider Contracting and/or Provider Services, including 2+ years ... sufficient network of Participating Providers to serve the health care needs of the Plan's patients or members, in...matrix leadership position * 3+ years experience in provider contract negotiations in a managed healthcare setting… more