- UTMB Health (Galveston, TX)
- … Care Management UTMB Health Requisition # 2505552 The mission of Correctional Managed Care is to address the healthcare needs of underserved patient ... for health services in compliance with ACA standards and UTMB Correctional Managed Care systems policies and departmental procedures. **_ESSENTIAL JOB… more
- Humana (Jefferson City, MO)
- …on average) Eastern Time Zone hours** **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid ... experience, and judgement to make determinations whether requested services, level of care , and/or site of service should be authorized. All work occurs within… more
- Caz Recovery (Buffalo, NY)
- …and family members. + Oversees regular consultation with other providers, legal agencies, managed care providers and other needed services; as well as oversight ... referrals, coordinates services and maintains regular ongoing consultations with other providers, managed care organizations, legal agencies, etc. + Ensures that… more
- University of Connecticut (UConn) (Storrs, CT)
- …+ Provide technical assistance and consultation on system design, service array, managed care , financing, youth and family partnership, and implementation and ... mobile response and stabilization, intensive in-home services, peer support, and intensive care coordination), managed care , financing, youth and family… more
- UCLA Health (Los Angeles, CA)
- …field required + Minimum of five (5) years' experience in a Medicare or Managed Care environment managing enrollment, claims or encounters required + Minimum of ... five (5) years' experience with CMS processes in a Medicare or Managed Care environment required + Experience with CMS processes is a plus + Knowledge of SQL… more
- Humana (Albany, NY)
- …and support member education. + Monitor competitive landscape and market trends across managed care programs; benchmark against industry best practices to inform ... teams to deliver business outcomes. + Experience in Medicaid managed care or government programs (MCOs), with working knowledge of state-specific… more
- J&J Family of Companies (Tucson, AZ)
- …to address critical access and affordability issues for patients + Partner with managed care colleagues to understand current policies and potential future ... solutions across multiple payer types and plans (ie, Medicare, Medicaid Managed Care , Commercial). + Execute business in accordance with the highest ethical,… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …policies and procedures to comply with medial staff bylaws, hospital bylaws, managed care policies, TJC/NCQA requirements and related state and federal ... + Five (5) years comprehensive Medical Staff Services in an acute care hospital, managed care or credentialing verification organization with three (3) years… more
- Molina Healthcare (West Valley City, UT)
- …in the health care field including, but not limited to, provider's office, managed care organization, or other health care environment. * 3+ years ... language. Assists with cost control strategies that positively impact the Medical Care Ratio (MCR) within each region. * Advises Network Provider Contract… more
- J&J Family of Companies (Manchester, NH)
- …to address critical access and affordability issues for patients. . Partner with managed care colleagues to understand current policies and potential future ... solutions across multiple payer types and plans (ie, Medicare, Medicaid Managed Care , Commercial). . Execute business in accordance with the highest ethical,… more