• Director of Pharmacy Benefit Manager Oversight

    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
    State of Massachusetts (12/04/25)
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  • Sr Director of Regional Operations

    Penn Medicine (Bala Cynwyd, PA)
    …Ensures practices are aligned with all standards. Supports implementation of managed care contracts and operational processes. Communicates performance targets ... practices + Knowledge of the medical environment, physician group practice, managed care , physician compensation, healthcare contracting and regulations,… more
    Penn Medicine (12/03/25)
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  • Surgical Services Coordinator Surgery Outpatient…

    Penn Medicine (Philadelphia, PA)
    …timeframes. Maintains comprehensive knowledge of reimbursement coverage from third party payers, managed care plans and protocols for referrals. + Additional ... protocols Maintains comprehensive knowledge of reimbursement coverage from third party payers, managed care plans and protocols for referrals. **Education and… more
    Penn Medicine (12/03/25)
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  • Behavioral Health Counselor LMSW LCSW LPC Lac

    Banner Health (Glendale, 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
    Banner Health (11/28/25)
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  • Counselor Behavioral Health

    Banner Health (Tucson, 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
    Banner Health (11/26/25)
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  • Utilization Management Registered Nurse

    Katmai (Fort Carson, CO)
    …DUTIES & RESPONSIBILITIES** + Act as coordinator/liaison with providers, staff and Managed Care Support Contractor (MCSC) to ensure that actual health ... care received is appropriate to meet TRICARE beneficiaries' healthcare...alternatives in healthcare, such as Medicare, Medicaid, and TRICARE Managed Support Contractors for which beneficiaries may be eligible.… more
    Katmai (11/26/25)
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  • Tele-Triage Licensed Practical Nurse- LPN

    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 conceLPNs + Actively participate in… more
    BrightSpring Health Services (11/25/25)
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  • Director Clinic Operations

    Dignity Health (Bakersfield, CA)
    …build strong relationships with providers and hospital leadership preferred. - Prior managed care or integrated delivery systems experience preferred - Master's ... will help our patients receive the highest standard of care , improve patient experiences and ensure the team delivers...full spectrum of medical and surgical specialties with each managed as discreet departments and integrated as part a… more
    Dignity Health (11/21/25)
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  • Sr Manager, Clinical Pharmacy Operations

    Point32Health (MA)
    …in pharmacy, and 2 years of supervisory experience. + Preferred: 1 - 2 years' managed care or PBM work experience. Experience supervising in an office or ... of the principles and practices of pharmaceutical science. Working knowledge of managed care and policy development. + Requires analytical ability, highly… more
    Point32Health (11/21/25)
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  • Utilization Management Reviewer

    AmeriHealth Caritas (Washington, DC)
    …+ Experience conducting prior authorizations and/or concurrent reviews within a managed care organization preferred **Licensure** + Active and unencumbered ... to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health… more
    AmeriHealth Caritas (11/20/25)
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