- Comunilife (Bronx, NY)
- …New York State Department of Health (NYS DOH), Health Home Lead agencies, and Managed Care Organization (MCO) requirements. The APD oversees the full continuum ... Strong understanding of NYS DOH Health Home standards, MAPP/HHTS workflows, and managed care billing requirements. + Experience using Foothold RMA or comparable … more
- Catholic Health Services (West Islip, NY)
- …not limited to, Medical Staff, Quality/Risk Management, CH Utilization and Central Appeals, Managed Care and Revenue Cycle and Patient Access departments to ... leadership role is required. + Experience in utilization management, working with managed care organizations, and discharge planning is required. + Current… more
- Community Health Systems (Franklin, TN)
- … care and patient care delivery. + Collaborate with the CHS Managed Care department to engage and negotiate with payers, health plans, and other ... dual reporting relationship with the MD VP for PPS and the VP of Managed Care Equal Employment Opportunity This organization does not discriminate in any way to… more
- Educational Alliance, Inc. (New York, NY)
- …and adherence to program standards. + Monitor compliance with Medicaid waiver requirements, managed care contracts, and Social Care Network (SCN) standards. ... readiness for external audits or site visits by regulatory agencies or managed care organizations. + Maintain up-to-date knowledge of Medicaid regulations,… more
- Elderwood (Buffalo, NY)
- …with at risk populations in home care , case management, discharge planning or managed care . + Minimum of one (1) year experience working with a frail ... and/or members with chronic illness or behavioral health issues. + Previous Managed Care experience, within a MLTC or working with special needs populations… more
- Catholic Health Services (Rockville Centre, NY)
- …positioning to increase preferred provider status with ACOs, health systems, and managed care organizations. + Negotiate and manage payer contracts (Medicare, ... Overview The VP of Post-Acute Care - Skilled Nursing Facilities is a senior executive...Medicaid, managed care , bundled payments). + Use operational...Medicaid, managed care , bundled payments). + Use operational and clinical data… more
- Molina Healthcare (Sparks, NV)
- …experience in hospital acute care , inpatient review, prior authorization, managed care , or equivalent combination of relevant education and experience. ... 2 years of experience with inpatient concurrent review, prior authorization and managed care ; Acute care hospital experience with discharge planning and… more
- Elderwood (Monroe County, NY)
- …(3) years nursing experience in home care , case management, discharge planning or managed care + Minimum of one (1) year experience working with a frail ... assessments in the Member's home to assess potential enrollees' appropriateness for Managed Long-Term Care (MLTC), or to reassess a member's status and needs. +… more
- UTMB Health (Huntsville, TX)
- …Patient Care UTMB Health Requisition # 2406235 The mission of Correctional Managed Care is to address the healthcare needs of underserved patient populations ... setting and supports licensed staff in the delivery of patient care within UTMB Correctional Managed Care . **_ESSENTIAL JOB FUNCTIONS_** **:** + Assists in… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …+ Strong multi-tasking abilities Preferred: + Experience working within a managed care environment Specific Technical Skills Preferred: Computer proficiency ... a multidisciplinary care team to assist with the care of members enrolled in our Managed Long Term Care program and facilitate authorization requests… more