- Molina Healthcare (Yonkers, NY)
- …experience in hospital acute care , inpatient review, prior authorization, managed care , or equivalent combination of relevant education and experience. ... unit (ICU) or emergency room. Preferred Experience Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of… more
- CVS Health (Richmond, VA)
- …mental health and substance abuse benefits, community treatment resources, mental health managed care programs, and Aetna policies and procedures * Works ... includes navigating multiple systems and keyboarding. **Preferred Qualifications** * Previous Managed Care experience. * Psychology or Social Services… more
- Diversicare Healthcare Services & Diversicare Ther (Brentwood, TN)
- …qualified referral sources **OTHER JOB DEMANDS:** + Knowledge and experience with Managed Care , Medicare, state specific Medicaid regulations and electronic ... as required by state of practice + Experience in the long term care industry or managed care organizations, preferred + Experience with Humana / Case… more
- Molina Healthcare (North Las Vegas, NV)
- …experience in hospital acute care , inpatient review, prior authorization, managed care , or equivalent combination of relevant education and experience. ... care unit (ICU) or emergency room. Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual… more
- Penn Medicine (Lancaster, PA)
- …Medicaid, and Tricare programs and such other third-party-payment programs, including managed care programs in which PMMG participates. Minimum Qualifications: ... Medicare, Medicaid, and Tricare programs and such other third-party-payment programs, including managed care programs in which PMMG participates. Benefits at a… more
- Beth Israel Lahey Health (Cambridge, MA)
- …and improve health outcomes. **Job Description:** **BILHPN President Population Health & Managed Care ** is responsible for developing and implementing a vision ... of care provided across our network. The President Population Health & Managed Care reports to the **BILH Chief Clinical Officer** and is responsible to the… more
- Health Care Service Corporation (Chicago, IL)
- …within the company.9.Provide leadership regarding negotiation of rates for traditional and managed care business. Conduct and assist in the negotiation process ... appropriate education/in-servicing is provided for providers. Education may pertain to managed care and areas where pertinent rulings/regulations could affect… more
- LA Care Health Plan (Los Angeles, CA)
- …gain strong knowledge of Medi-Cal and Personal Assistance Services Council (PASC) managed care product lines. The Customer Solution Center Service Representative ... with ability to type a minimum of 40 words per minute. Preferred: Managed care or health plan experience. Skills Required: Ability to answer a high volume… more
- LA Care Health Plan (Los Angeles, CA)
- …Solution Center (CSC) Representative II has advanced knowledge of healthcare and various managed care product lines, including Medi-Cal, PASC, LA Care ... experience with ability to type a minimum of 40 wpm. Preferred: Managed care or health plan experience. Previous Automatic Call Distribution (ACD) experience… more
- Athena Health Care Systems (Southbridge, MA)
- …on non-completed sections of MDS. + Retrieves/Prints and faxes medical records to managed care companies for utilization review purposes. + Transmits MDSs to ... individuals, regardless of personal characteristics, are encouraged to apply. Athena Health Care Systems and its managed facilities/agencies follow federal and… more