- Trinity Health (Grand Rapids, MI)
- …operational initiatives including new services/programs, revenue enhancement, expense reduction, managed care utilization systems, and strategies. Responsible ... people, processes and / or programs that support direct or indirect patient care . Promotes and advocates for patients, pharmacists / colleagues and the practice of… more
- Centene Corporation (New York, NY)
- …Clinical Psychology or Clinical Social Work. Three years clinical experience in a health care environment; managed care experience desired. **For Fidelis ... in the review and determination of coverage for medically necessary health care services. Answers Utilization Management directed telephone calls; managing them in a… more
- Providence (OR)
- …with a health care provider, a health insurance company, or a capitated managed care company. + 5 years of excellent writing and grammar skills required. ... team and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your...well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering… more
- Kaniksu Community Health (Sandpoint, ID)
- …health care and is responsible for quarterly BH peer review and BH Managed Care Reporting. + Oversees the BH Services daily staffing requirements; plans and ... patient and healthcare service programs meet accepted standards of care . + Direct Supervisor for all BH Providers +...+ Supervises and coordinates the delivery of behavioral health care + Plans and oversees behavioral health activities +… more
- St. Luke's University Health Network (Sellersville, PA)
- …organized fashion. + Provides clinically related tasked such as correspondence, completion of managed care forms, and works in assuring services are authorized ... which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses...sick and injured; educate physicians, nurses and other health care providers; and improve access to care … more
- Kaleida Health (Buffalo, NY)
- …case management, inpatient, outpatient, and the home health continuum, as well as managed care utilization management and coordination of care . Incumbent ... Full-Time** **Shift 1** **Job Description** **Responsible for coordination of care at designated site, inclusive of care ...of care at designated site, inclusive of care path facilitation, data collection and application of criteria… more
- AmeriHealth Caritas (Columbia, SC)
- … care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral ... We are looking for the next generation of health care leaders. **This position is remote however, you must...AmeriHealth Caritas, we are passionate about helping people get care , stay well and build healthy communities. As one… more
- Modivcare (Denver, CO)
- …Deep understanding of healthcare markets, including Medicaid, Medicare Advantage, and managed care organizations. + Expertise in developing differentiated ... environments, market needs, and Modivcare's mission to improve access to care . Product Positioning and Messaging + Defines clear, differentiated value propositions… more
- Banner Health (Tucson, AZ)
- …Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options ... Shift:** Day **Job Category:** Risk, Quality and Safety Health care is constantly changing, and at Banner Health, we...the front of that change. We are leading health care to make the experience the best it can… more
- CommonSpirit Health (Rancho Cordova, CA)
- …supervisory role highly preferred + Experience in Utilization Management, Case Management or Care Coordination, Managed Care is preferred **Where You'll ... Determine facility designation based on diagnoses, planned procedure and level of care requirements + Maintain constant communication with both internal and external… more