- Providence (Mission Hills, CA)
- …+ HMO products, industry claims processing procedures, contracts, billing and overall managed care processes, etc. + Proficiency and experience in using ... Medical Foundation and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters… more
- Penn Medicine (Philadelphia, PA)
- …timeframes. * Maintains comprehensive knowledge of reimbursement coverage from third party payers, managed care plans and protocols for referrals. * Ensures all ... 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
- Point32Health (Canton, MA)
- …industry **Experience** + Required (minimum): A minimum of 5-7 years' experience Managed Care , preferably at a Health Plan, in a ... Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to... and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture… more
- Whitney Young Health Center (Albany, NY)
- …a physician office setting. + Basic computer keyboard knowledge. + Knowledge of managed care requirements. + Familiarity with target population and community ... and flexibility, assists the medical providers to provide maximum quality patient care . Maintains an efficient, effective means of patient flow within the medical… more
- Beth Israel Lahey Health (Boston, MA)
- …referral and authorization rules and related policies for multiple insurance and managed care payers, including transplant-specific policies; maintains record of ... program to assist in the safe delivery of patient care . Additional support staff of the Heart Transplant department...patients during the evaluation, pre-operative, and post-transplant phases of care helps to ensure that all groups are involved… more
- Beth Israel Lahey Health (Milton, MA)
- …update inventory system when needed. Accurately inputs patient insurance and managed care plans, including prior authorizations, referrals, and precertification. ... day to day supervision of administrative staff within the Center for Specialty Care . This role provides oversight of time and attendance in addition to payroll… more
- Abbott (Hauppauge, NY)
- …new sales in expanded marketplace. + Collaborate with various channels partners within HCP, Managed Care , Retail, and Point of Care organizations. + ... you can do work that matters, grow, and learn, care for yourself and your family, be your true...position is a remote opportunity in the Abbott Diabetes Care Division. We are helping people with Diabetes lead… more
- Corewell Health (Grand Rapids, MI)
- …of relevant experience in clinical setting Required + 3 years of relevant experience Managed care experience Required + Proven experience and evidence of success ... Expectations will include: A strong understanding of the guiding principles of; Right care , Right time, Right place, Right cost. This strong understanding of the… more
- Humana (Indianapolis, IN)
- …**Preferred Qualifications** + Familiarity with Illinois -based BH organizations + Medicaid Managed Care clinical or behavioral health leadership experience + ... of use; consultations and clinical guidance for contracted primary care Providers (PCPs) treating behavioral health‐related concerns not requiring referral… more
- Centene Corporation (Columbus, OH)
- …psychiatry or child psychiatry. + 5+ years of experience working in behavioral health managed care or behavioral health clinical settings, with at least 2 years ... goals and policies to improve quality and cost-effectiveness of care and service for members. + Provides medical expertise...membership. + Conduct regular rounds to assess and coordinate care for high-risk patients, collaborating with care … more
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