- Fallon Health (Worcester, MA)
- …**License/Certifications:** Massachusetts Nursing Licensure **Experience:** + Broad experience in managed care and /or integrated delivery systems, either ... + Minimum of ten years clinical experience, at least five in managed care or ambulatory clinical operations. **Pay Range Disclosure:** In accordance with the… more
- Elevance Health (Norfolk, VA)
- …acute care setting. + Minimum 2 years "telephonic" Case Management experience with a Managed Care Company. + Managed Care experience. For candidates ... will be required.** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic… more
- Banner Health (Chandler, AZ)
- …proficient with commonly used office software. PREFERRED QUALIFICATIONS Previous knowledge of managed care concepts. Working knowledge of medical terminology and ... payers. The position must work with and understand the concepts of managed health care and be able to prioritize tasks within established guidelines with… more
- Valor Health (Bowling Green, KY)
- …VA and works with these patients utilizing rules set forth by the VA for co- managed care . + Conducts individual, group, and family and marriage counseling and/or ... reminders "due" at the time of each patient visit. + Assists in co- managed care collaboration with non-VA providers, and facilities. + Functions as case manager… more
- Immigration and Customs Enforcement (Washington, DC)
- …status of individuals placed on SMI (Serious Mental Illness List). Work with Managed Care Coordinators to absorb Accessibility to Healthcare Services component ... Fiscal Year (FY) 2021, the ICE Health Service Corps (IHSC) administered and managed a health care system that provided direct care to over 88,000 detainees… more
- Dignity Health (Rancho Cordova, CA)
- …in Healthcare Quality (CPQH), Certified Healthcare Auditor (CHA) preferred. - 2 years managed care experience preferred. - 1 year delegation oversight experience ... CMS and other regulatory bodies preferred - Knowledge of HIPPA, managed care environment preferred - Strong technical proficiency in data analysis; database… more
- Valor Health (Dickinson, ND)
- …with front desk for check-in, check-out and phone coverage. + Assist in co- managed care collaboration with non-VA providers, and facilities. + Provide patient ... to federal government service. We aim to deliver high-quality care in a way that upholds the health of...working with parent VAMC schedulers to ensure appointments are managed and no conflicts with telehealth rooms and equipment.… more
- Sutter Health (San Francisco, CA)
- …knowledge base of health care delivery and case management within a managed care environment. + Comprehensive knowledge of Utilization Review, levels of ... for Medicare and Medicaid Services (GR) Grouper (CMS), Department of Managed Health Care , National Committee for Quality Assurance (NCQA). + A broad knowledge… more
- Banner Health (Scottsdale, AZ)
- …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
- State of Massachusetts (Boston, MA)
- …collaboration with staff from the Health Care Access Bureau and Bureau of Managed Care to advise the Commissioner about issues that may impact future ... the insurance market that have implications in health insurance mandates and managed care practices. * Manage staff working in Pharmacy Benefit Manager Oversight… more