- AdventHealth (Orlando, FL)
- …Information Management (HIM), Revenue Cycle, Patient Financial Services, Patient Access, AHS Managed Care departments and applicable medical staff of specific ... changes related to denial prevention measures for our contracted managed care payers. The PA role is...CFO/Sr VP, Vice President of Revenue Cycle Operations and/or Executive Director Middle Revenue Cycle/Utilization Management. Reviews… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …as an independent, the Compliance Specialist's primary function is to ensure the Managed Care business unit is meeting compliance with rules, policies, and ... JOB SUMMARY: Reporting to the Director of Claims and Systems Administration and functioning...changes, legislative efforts, and /or industry trends specific to Managed Care operations and keeps Management Team… more
- UPMC (Washington, PA)
- …the continuum of care . **Responsibilities:** + Develops reporting tools to assist Director and executive leadership teams to assess the effectiveness of Case ... the Case management department under the direction of the Director . The Manager is accountable for the following Case...Medicare, Medicaid, and other third party payor requirements, and managed care principles preferred.2. Use of expert… more
- HCA Healthcare (Loxahatchee, FL)
- …contracting issues. + Provides medical consultation on contracting, pricing, and analysis of managed care issues. Offers clinical support for appeals and denials ... regarding delegated utilization management and disease management operations under managed care contracts. Meets all regulatory/contractual/accreditation requirements… more
- CVS Health (Lansing, MI)
- …and health care industry. At least three years of experience Medicaid and managed care experience. Must be a physician with a current, unencumbered license ... to the Health Plan CEO, COO, CFO and other executive team members in Medicaid driving clinical excellence, achieving...Qualifications** 1. Demonstrated experience in population health management and Managed Care . 2. Passion and ability to… more
- CenterWell (Columbia, SC)
- …fairly and objectively, in consultation with the Human Resources Department and the Executive Director / Director of Operations. + Participates in the ... caring community and help us put health first** Reports To: Associate Director , Home Health Branch Administrator FLSA: Exempt **Work Schedule** : Full-time/40 Hours… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …of Experience Required: Administrative, coordination, communications, education Preferred: Training, Managed Care , Sales Specific Technical Skills Required ... projects. PRIMARY RESPONSIBILITIES: + Perform general administrative, clerical, and executive support tasks + Collaborate with the Director...+ Able to work in a fast-paced environment + Managed long-term care knowledge + Medicaid knowledge… more
- Rush University Medical Center (Chicago, IL)
- …with the Rush System for Health entities and leaders. Reporting to the Executive Director -Cancer along with a dotted line reporting relationship to the ... services are provided to ensure patient needs are met across the continuum of care . * Collaborates with the Nursing Executive Team, Chief Nursing Officers, Rush… more
- AmeriHealth Caritas (Washington, DC)
- …Five (5) years of progressive medical management leadership is required. Managed care organization leadership experience as a Medical Director or CMO is ... care initiatives. The Market CMO is a clinical executive responsible for interacting with the plan membership, community,...levels within the plan and enterprise organizations, providers, other managed care organizations, and the state and… more
- State of Massachusetts (Boston, MA)
- …Boston Child, Youth, and Family team. The HSC-II will provide oversight of case- managed youth in DMH community services and statewide programs, as well as liaison ... community partners. The HSC-II promotes DMH's philosophy of recovery, trauma informed care , person, youth and family centered choices and cultural humility. Primary… more