- Prime Therapeutics (Salem, OR)
- …area of study + 15 years of relevant work experience in PBM, pharmacy, health plan and/or managed care with a minimum of 8 years in Medicare and/or Medicaid in a ... **Job Posting Title** VP Government Programs - Medicare & Managed Medicaid (REMOTE) **Job Description** The Vice President Government...of PBM. We're reimagining pharmacy solutions to provide the care we would want for our loved ones. That… more
- WellSpan Health (York, PA)
- …recurrent authorizations are present to ensure timely reimbursement. Assists with coordination of care and/or transfers to higher levels of care . Refers patients ... completion and submission of applications for public assistance or uncompensated care . Provides support to multiple provider types in behavioral health authorization… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …position prefers proficiency in Arabic, Dari-Farsi, Farsi or Pashto** JOB SUMMARY: The Lead Care Manager (LCM) operates a as a member of the patient's Enhanced ... Care Management (ECM) team and is responsible for coordinating...agencies or community service providers that are engaged in care coordination activities. The LCM will enroll patients in… more
- US Tech Solutions (Columbia, SC)
- …plan, implement, health coach, coordinate, monitor, and evaluate medical necessity and/or care plan compliance, options, and services required to support members in ... staff (Medical Director, Case Manager, Preventive Services, Subrogation, Quality of Care Referrals, etc.). Participates in data collection/input into system for… more
- Rady Children's Hospital San Diego (Temecula, CA)
- …health condition(s), reinforce teaching, and/or provide coaching to sustain teaching and Care Plan from Care Management Team, and help patients/families develop ... patient families to adopt healthy behaviors. The CHW supports providers and the Care Management Team through an integrated, holistic approach to care management… more
- CVS Health (Woonsocket, RI)
- …ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions ... jargon. **Required Qualifications** 1-3 years experience in a health care , pharmacy or medical billing environment **Preferred Qualifications** + Intermediate… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …diagnosis, family violence, child-protection, and bio-ethical issues * Experience working in an acute- care hospital setting * Registered as an ASW with the Board of ... family violence, child protection, and bio-ethical issues Experience working in an acute- care hospital setting Certification in Clinical Supervision in the State of… more
- Athena Health Care Systems (Middletown, CT)
- …on non-completed sections of MDS. + Retrieves/Prints and faxes medical records to managed care companies for utilization review purposes. + Transmits MDSs to ... of personal characteristics, are encouraged to apply. Athena Health Care Systems and its managed centers follow...apply. Athena Health Care Systems and its managed centers follow federal and state mandatory guidelines regarding… more
- Martin's Point Health Care (Portland, ME)
- …Experience + 2 years of experience working as a pharmacy technician in a clinical, managed care or community pharmacy setting. + Experience in a clinical or ... non-dispensing role (ambulatory care , managed care , quality management). Knowledge + Knowledge of Medicare Part D, Stars, and HEDIS quality measures. +… more
- Health Care Service Corporation (Nashville, TN)
- …of operations within 90 days of hire. + Plus 3 years' wellness or managed care experience presenting clinical issues with members/physicians. + Knowledge of the ... your professional development. **Job Summary** This position is responsible to provide care coordination to members via telephonic and/or field-based care … more