- Point32Health (MA)
- …Experience with McKesson's InterQual Clinical Screening Criteria. + Preferred: 3 years in a managed care environment in managed care systems and ... Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to... and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture… more
- Humana (Webster, WI)
- …to building vibrant and inclusive communities, Inclusa deploys a unique approach to managed care with a trademarked model of support named Commonunity(R) which ... vibrant and inclusive communities, Inclusa deploys a unique approach to managed care with a trademarked model of support named Commonunity(R) which focuses… more
- CenterWell (Corpus Christi, TX)
- …**Preferred Qualifications** + Basic knowledge of Population Health Strategy + 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
- Banner Health (Loveland, CO)
- …with physicians and peers. 5. May provide clinical updates to representatives of managed care to assure coordination and reimbursement of treatments services. ... levels of clinical staff in assigned program, physicians. External contacts include managed care providers, community resources, and referral agencies. 8. May… more
- Centene Corporation (Getzville, 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
- Molina Healthcare (Madison, WI)
- …experience, 3 years utilization/quality program management experience, and 2 years managed care experience, or equivalent combination of relevant education ... (PBM), Group/IPA practice, capitation, health management organization (HMO) regulations, managed health care systems, quality improvement, medical utilization… more
- HCA Healthcare (Orem, UT)
- …contracting issues. + Provides medical consultation on contracting, pricing, and analysis of managed care issues. Offers clinical support for appeals and denials ... Consults with facility-level staffregardingdelegatedutilizationmanagement and disease management operations under managed care contracts. Meets all regulatory/contractual/accreditation requirements… more
- System One (Las Vegas, NV)
- …healthcare-related field preferred + Three (3) years of experience in case management and/or managed care required + Experience in a Medicare and/or Medicaid ... managed care environment preferred Post-acute, home care , waiver, or acute clinical care experience preferred Competencies, Knowledge and Skills: +… more
- Abbott (Gainesville, FL)
- …meeting or exceeding sales quotas/objectives for ADC Products. Collaborate with various channels, Managed Care and Retail and Point of Care representatives. ... sales quotas/objectives for ADC Products. + Collaborating with various channels, Managed Care , Retail, and Point of Care representatives. + Establishing… more
- Corewell Health (Grand Rapids, MI)
- …/ community outcomes through the application of educational concepts / skills and preventive care in a managed care environment. Qualifications + Bachelor's ... Required + 3 years of relevant experience clinical nursing and or case management/ managed care or related field Required + LIC-Registered Nurse (RN) - State of… more
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