- Centene Corporation (Westbury, NY)
- …including "metal" products offered through the New York State of Health (NYSOH), Medicaid Managed Care , Child Health Plus, Medicare, MLTC, FIDA and HARP. Ability ... diploma or GED, required. 2 to 5 years prior experience in managed care , sales, customer service or related experience preferred. Basic computer skills.… more
- Elevance Health (Wilmington, DE)
- …care setting preferred. + Minimum 2 years' "telephonic" Case Management experience with a Managed Care Company preferred. + Managed Care experience ... meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic… more
- BrightSpring Health Services (Colorado Springs, CO)
- …responding to customer requests and concerns, and negotiating service contracts with managed care organizations, government agencies, and other payers. Evaluates ... maximum third-party reimbursement through effective negotiation of service contracts with managed care organizations, government agencies, and other payers +… more
- HCA Healthcare (El Paso, TX)
- …private payer regulations and processes, and possesses a thorough understanding of managed - care concepts and length-of-stay management relating to patient and ... payer regulations and processes. You will possess a thorough understanding of managed - care concepts and length-of-stay management relating to patient and… more
- BrightSpring Health Services (Louisville, KY)
- …for productivity management to assigned supervisor + Notify each practice, physician, and/or managed care client of all encounters with patients, parents, or ... managed care clients regardless of follow-up needs before office opening + Notify designated leadership of operational concerns + Actively participate in… more
- CenterWell (Kissimmee, FL)
- …an organization focused on continuously improving consumer experiences + Medicare knowledge + Managed care experience + Value Based Care knowledge ... member of an interdisciplinary team + Solid understanding of medical care delivery, managed care financial arrangements and reimbursement + Bachelor's… more
- Mount Sinai Health System (New York, NY)
- …and governmental programs, regulations, and billing processes (eg, Medicare, Medicaid, etc.), managed care contracts and coordination of benefits is required. ... government payers, applicable federal and state regulations, healthcare financing and managed care . + Expected to stay updated on current medical billing and… more
- CenterWell (Phoenix, AZ)
- …etc. **Required Qualifications** + Bachelor's Degree + 5 or more years of Health care or managed care with Provider Contracting, Network Management or ... a must. strong, knowledgeable provider engagement professional - Preferably in the managed care space (Medicaid/Medicare) + Proven planning, preparation and… more
- Penn Medicine (Lancaster, PA)
- …to tolerate high volume production standards. **Preferred Qualifications:** + Knowledge of health care and managed care delivery systems. This includes ... utilization management and quality improvement processes. + Experience working within the managed care environment. \#LI-LJ1 We believe that the best care … more
- Pacific Medical Centers (Renton, WA)
- …or equivalent experience in Health Care Business Administration. + 2 years in Managed Care operations. + 1 year of Claims processing experience, in a TPA, ... Health and Encounters). + Information systems supporting the administration of managed care products. **Preferred Qualifications:** + IDX healthcare software… more