- AdventHealth (Maitland, FL)
- …Equiv 4 of experience in managed care, hospital revenue cycle/patient financial services or healthcare insurance / provider relations related background Required ... supervision, provides necessary research, review and interpretation of Insurance Provider Manuals, payment methodologies, and reimbursement rates. Maintains a strong… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …with leaders in Provider Relations and Pharmacy to ensure all health services solutions are integrated and aligned to deliver on our mission of paving the ... to internal and external stakeholders and working through our Provider Relations Team to assure the delivery of high...collaborate closely with the leadership of Commercial, Medicare, and Medicaid product lines to ensure they meet the unique… more
- Alameda Health System (San Leandro, CA)
- …Medical Officer and Department Chair, ensures adequate clinical access to services ; this includes evaluating and ensuring provider -level productivity, including ... Licenses/Certifications: Provider in good standing in the Medicare and Medicaid programs; compliance with Board mandated education and training to maintain State… more
- Molina Healthcare (Tampa, FL)
- … provider contracting experience. + Experience with NCQA, HEDIS, Medicaid , Medicare and Pharmacy benefit management, Group/IPA practice, capitation, HMO ... policies and procedures that guide and support the provisions of medical staff services . Maintains a working knowledge of applicable national, state, and local laws… more
- Huron Consulting Group (Chicago, IL)
- …reduce the cost of providing patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. ... As a Senior Director with our Healthcare team, you will lead complex healthcare consulting engagements, creating high-performing environments and ensuring successful… more
- AmeriHealth Caritas (Southfield, MI)
- …of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate ... integrated managed care products, pharmaceutical benefit management and specialty pharmacy services , behavioral health services , and other administrative … more
- NORC (Washington, DC)
- …at the University of Chicago seeks an experienced Senior Research Scientist to lead and contribute to prescription drug programs and policy projects, with an ... care delivery, from private marketplaces and employer-sponsored insurance to Medicare and Medicaid ; from large health care systems to small clinics; and from the… more
- Peak Vista (Colorado Springs, CO)
- …to people facing access barriers through clinical programs and education. We provide integrated health care services including medical, dental, and behavioral ... Pikes Peak and East Central regions of Colorado. Our service area covers 14 counties, from the front range...delivering exceptional, equitable care. Essential Duties and Responsibilities: + Lead and monitor QI/PI projects in alignment with the… more
- New York State Civil Service (Schenectady, NY)
- …and coincides with the expectations of the core mission of OPWDD to provide necessary services to individuals with disabilities. The incumbentwill perform ... the state. PRIMARY DUTIES AND RESPONSIBILITIES:* Assist the Department Lead with receiving, reviewing, and processing service ...Field Office in local & statewide meetings regarding OPWDD Services and changes in the service delivery… more
- Fallon Health (Worcester, MA)
- …improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and ... continually rated among the nation's top health plans for member experience, service , and clinical quality. We believe our individual differences, life experiences,… more