- PruittHealth (Warner Robins, GA)
- …offices. 7. Identifies key referring personnel in hospitals, nursing homes, and managed care operations, along with opportunities to increase referral volume ... to drive growth in our skilled nursing, rehabilitation and long-term care business. **KEY RESPONSIBILITIES:** 1. Develops, implements, and evaluates quarterly and… more
- Penn Medicine (Radnor, PA)
- …timeframes. Maintains comprehensive knowledge of reimbursement coverage from third party payers, managed care plans and protocols for referrals. **Education or ... our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future...lieu of some experience. We believe that the best care for our patients starts with the best … more
- Northwell Health (New Hyde Park, NY)
- …pharmacy experience post-licensure, with a significant portion (4+ years) directly in a managed care organization, Pharmacy benefit manager, or health plans + ... to support P&T Committee decisions and ensure cost-effective, high-quality pharmaceutical care for plan members. **Job Responsibility** + Develops and monitors the… more
- Humana (Salem, OR)
- …+ Bachelor's Degree and/or equivalent experience + 8 or more years of Health care or managed care with Provider Contracting, Network Management or ... + Proficiency in analyzing and interpreting financial trends for health care costs, administrative expenses and quality/bonus performance + Comprehensive knowledge… more
- Bristol Myers Squibb (Princeton, NJ)
- …Strong understanding of Model N US Revenue Management modules (eg, Chargebacks, Managed Care , Government Pricing, Medicaid, Commercial Rebates) and their ... then in effect and may include the following: Medical, pharmacy, dental and vision care . Wellbeing support such as the BMS Living Life Better program and employee… more
- Centene Corporation (Tallahassee, FL)
- …treatment plans related to mental health and substance abuse across the continuum of care required Experience with managed care , case management, utilization ... Health required** **:** 4+ years experience providing behavioral health outpatient care in a community setting or independent practice required Experience with… more
- Intermountain Health (Las Vegas, NV)
- …+ Proactive Care + Risk-based Contracting + Relationship Management + Managed Care + Legal Practices + Leadership **Required Qualifications** + Experience ... Revenue Cycle leadership for the implementation of risk-based contracting, and proactive care , strategies and initiatives. + Coordinates with Legal and Compliance to… more
- University of Miami (Medley, FL)
- …for patient information, insurance information, service descriptors, diagnosis codes and managed care authorization requirements, and coordinates corrections. + ... to payers and other recipients. + Coordinates insurance reimbursements with care providers. + Adheres to University and unit-level policies and procedures… more
- Tufts Medicine (Boston, MA)
- …steps that need to be completed. 8. Assists patients with enrollment in Managed Care /ACO plans, enrollment via the Health Connector, employer sponsored ... process of obtaining benefits so they can access the care they need and to ensure reimbursement to Tufts...diploma or equivalent 2. One (1) year of hospital/health care experience in the areas of Patient Access. 3.… more
- Trinity Health (Pontiac, MI)
- …proper sequence and according to the rules of the system, which may include managed care requirements and clinical standards. 7 Informs surgeon or confirms with ... proficient with the electronic health records for documentation, assessment, and care management, performing these activities concurrently with provision of care… more