- Santa Clara Family Health Plan (San Jose, CA)
- …Care , Public Assistance or Human Services programs. (R) Prior experience with managed care plans, Medi-Cal and Medicare programs, and working with underserved ... populations. (D) Ability to meet Key Performance Indicators by participating in and achieving the standards of the Customer Service Call Center Quality Program. (R) Spanish, Vietnamese, Chinese, or Tagalog language bi-lingual skills. (D) Working knowledge of… more
- Ameritas (Las Vegas, NV)
- …This role is continually challenged to develop provider networks in a competitive managed care marketplace. Network development needs change and increase on a ... paternity leave Fertility, surrogacy and adoption assistance Backup child, elder and pet care support An Equal Opportunity Employer Ameritas has a reputation as a… more
- BankTalent HQ (Midvale, UT)
- …business areas. The successful candidate will have experience with handling pharmacy contracts, managed care contracts, or other contract background; be able to ... Leave and Adoption Assistance Health Savings (HSA), Flexible Spending (FSA) and dependent care accounts Paid Training, 15 days of Paid Time Off (PTO). (PTO covers… more
- CareSource (Dayton, OH)
- …Minimum of three years of health care operations experience in insurance, managed care , or related industry is required Competencies, Knowledge and Skills: ... Knowledge of regulatory reporting and compliance requirements Ability to effectively interact with all levels of management within the organization and across multiple organizational layers Demonstrates excellent analysis and collaboration skills Ability to… more
- Santa Clara Family Health Plan (San Jose, CA)
- …management, utilization management, discharge planning and/or quality improvement in a managed care related setting. (R) Understanding and/or experience with ... of UM operations such as prior authorization, concurrent review, Transitional Care Services (TCS), and discharge planning into other internal and external… more
- CareSource (Las Vegas, NV)
- …understanding of claims operations, configuration, and clinical editing specifically related to managed care Understanding of CPT, HCPCs and ICD-CM Codes, ... processing edits and logic Familiar with CMS guidelines / HIPPA and Affordable Care Act Familiarity with reporting packages and running system reports Licensure and… more
- UnitedHealth Group (Las Vegas, NV)
- …OASIS documentation Discharge and referral process Rehabilitation and social work services Managed care payors You'll be rewarded and recognized for your ... performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: Graduated from an accredited school of… more
- Olympus Corporation of the Americas (Center Valley, PA)
- …field lead to develop strategic implementation plans to influence targeted national/regional managed care customers to ensure favorable market access policy of ... True to Life, by advancing medical technologies and elevating the standard of patient care so people everywhere can fulfill their desires, dreams, and lives. ? Our… more
- TEKsystems (Vail, CO)
- …with Cerner, Oracle, EMR, and EHR systems * Knowledge of billing processes and managed care contracts * A passion for customer service and continuous improvement ... talented team in a *state-of-the-art facility* dedicated to delivering exceptional patient care . * We offer relocation assistance and employee housing support to… more
- CareSource (Las Vegas, NV)
- …other job duties as requested Education and Experience: Associate's Degree required Managed care , appeals, Medicare, and Medicaid experience preferred Prior ... to navigate complex regulations while maintaining a commitment to high-quality care Strong written and oral communication skills Ability to work independently… more
