- Bon Secours Mercy Health (Cincinnati, OH)
- …areas highlighted by the OIG, Medicare, State Medicaid, State Insurance Fraud; Managed Care or Governmental Value-Based payment programs and/or other enforcement ... Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, ...care quality, safety and cost effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …patient care , efficient use of clinical resources, and compliance with managed care contractual obligations. + Tracks operational metrics to support ... daily operations to ensurethe Section is providing quality patient care and maximizing patient flow. + Supports the achievement...the return of charge slips from satellites. + Patient Care and Advocacy: + Evaluates daily operations to ensure… more
- Humana (Baton Rouge, LA)
- …skills + 5 years of established clinical experience + Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products + ... *Oversee regional utilization management and case management for inpatient cases (acute care hospital, LTAC, Acute rehab, SNF) according to the Humana Medicaid Model… more
- UTMB Health (Conroe, TX)
- …States** Allied Health UTMB Health Requisition # 2500994 The mission of Correctional Managed Care is to address the healthcare needs of underserved patient ... Juvenile Justice Department (TJJD). **_JOB SUMMARY_** **:** Provides comprehensive pharmaceutical care to patients on a given medical service. **_ESSENTIAL JOB… more
- City of New York (New York, NY)
- …needs. - Strengthen collaboration with community-based organizations, healthcare organizations, managed care organizations, and government agencies to improve ... and healthcare systems in partnership with community, faith-based, and health care organizations. CHECW's work focuses on social determinants of health, including… more
- ChenMed (Delray Beach, FL)
- …and linguistically diverse setting is essential + Experience working within a managed care environment strongly preferred **PAY RANGE:** $292,097 - $417,282 ... you inspire others with your kindness and joy? We're different than most primary care providers. We're rapidly expanding and we need great people to join our team.… more
- BrightSpring Health Services (Cleveland, OH)
- …contract negotiations with agencies, funding sources, facilities, insurance companies, and managed care organizations + Supports and promotes company philosophy ... health solutions for complex populations in need of specialized and/or chronic care . Through the Company's service lines, including pharmacy, home health care… more
- Trinity Health (Fresno, CA)
- …+ Strong communication and relationship-building skills. + Knowledge of Medicare regulations and managed care . + Ability to multitask across multiple systems. + ... we serve. Your mission is to help patients and families access compassionate care by building strong relationships with healthcare providers and facilities in your… more
- Mindoula Health (WA)
- …appropriate resources and coordinate with the Substance Use Disorder Program team, primary care providers, managed care organizations, and community agencies ... this role, you will follow the Substance Use Disorder Program guidelines to plan care , assess client needs, and complete screenings. You will also refer clients to… more
- Humana (Gainesville, FL)
- …Qualifications** + Bachelor's degree in Nursing + 3 or more years years of managed care experience + 3or more years years of case management experience ... pilot strategies that will support Humana provider specific measure care gap closure. - 40% will include provider in...specific strategies + Provider and Member outreach on focused care gap measures + EMR remote strategy for Humana… more