- Trinity Health (Mason City, IA)
- …and revenue loss. Patient outcomes are achieved through effective application of care plans, managed care concepts, appropriateness criteria, resource ... What you'll do: + Works directly with members of care team to effectively ensure appropriate acute utilization management...for benefits eligibility and communicate with patient and health care team when benefits and plan of care… more
- Dignity Health (Bakersfield, CA)
- …care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, ... In-Patient Utilization Management teams to ensure appropriate and cost-effective care . Key functions involve: - Authorization Review: Proactively, concurrently, or… more
- Henry Ford Health System (Detroit, MI)
- …management techniques and applications; and healthcare administration, including managed care administration, regulatory management, government regulations, ... a full continuum of services - from primary and preventative care to complex and specialty care , health insurance, a full suite of home health offerings, virtual… more
- Sacramento Behavioral Healthcare Hospital (Sacramento, CA)
- …Coordinate transfer of accepted patient. + Verify insurance, obtain pre-authorizations with the managed care organizations in a timely manner. + Register the ... with patients, the patient's significant others, and the appropriate health care providers, collects and analyzes data regarding the patient's physical,… more
- Sanford Health (Bemidji, MN)
- …abreast of regulatory processes and payer systems such as Medicare, Medicaid, managed care , and private sources, as applicable. Demonstrate extensive advanced ... provides expert clinical guidance in a specialized field and coordinates patient care quality initiatives. This role will require varying shifts, on-call rotations,… more
- Sanford Health (Worthington, MN)
- …abreast of regulatory processes and payer systems such as Medicare, Medicaid, managed care , and private sources, as applicable. Demonstrate extensive advanced ... (PA) provides expert clinical guidance in a specialized field and coordinates patient care quality initiatives. Provides service to patients in acute, short and long… more
- Penn Medicine (Radnor, PA)
- …pertinent to patient service and billing procedures: including basic knowledge of all managed care plans UPHS participates with and which insurers require a ... is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field… more
- Penn Medicine (Lancaster, PA)
- …Medicare, Medicaid, and Tricare programs and such other third-party-payment programs, including managed care programs in which LGMG participates. **Benefits at a ... our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future...walk-in clinic designed to bridge the gap between primary care and urgent care . Our team provides… more
- CVS Health (Phoenix, AZ)
- …Behavioral Analysis Therapy experience preferred. + 1+ year of experience in a managed care organization (MCO). + Experience in a high-volume clinical call ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- Sanford Health (Rapid City, SD)
- …abreast of regulatory processes and payer systems such as Medicare, Medicaid, managed care , and private sources, as applicable. Demonstrate extensive advanced ... provides expert clinical guidance in a specialized field and coordinates patient care quality initiatives. This role will require varying shifts, including nights,… more