- Prime Therapeutics (Trenton, NJ)
- …experience in clinical operations, quality, network, pharmacy or project management OR a managed care pharmacy residency. + Proven ability to plan, organize, ... of account(s). + Ensures revenue goals are met, cost of care and administrative expenses managed , and EBIDTA targets achieved for the assigned account(s). +… more
- Banner Health (Mesa, AZ)
- …Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options ... Name:** AZ Radiology Sales/Svcs-Bio-Me **Work Shift:** Day **Job Category:** Clinical Support Health care is constantly changing, and at Banner Health, we are at the… more
- Catholic Health Services (Roslyn, NY)
- …Knowledge: + Stay updated on requirements from third-party payers, regulatory agencies, and managed care entities regarding levels of care , continuity of ... benefits, and medical necessity guidelines. + Awareness of managed care practices and the latest trends in patient care . Salary Range USD $25.00 - USD $35.00… more
- Penn Medicine (Princeton, NJ)
- …the assessment and evaluation of patients seeking psychiatric/behavioralhealthcare in a managed care environment. Demonstrates competency in assessing children, ... competency with suicide risk assessments and crisis intervention. + Works with managed care companies to determine level of care needed by providing… more
- Outreach Development Corporation (Ridgewood, NY)
- …relationships with referents and other collateral contacts (ie, Probation, Parole, CPS, managed care , EAP's, courts, etc.) through timely written, phone, ... services. . Conduct toxicology testing as needed. . Oversee and/or coordinates care with managed care organizations of identified clients who need either… more
- UPMC (Pittsburgh, PA)
- …ability to learn new software applications required. + Three years experience in a managed care environment preferred + Five years of experience with community ... rate. The Social Worker assists UPMC Health Plan members who require care coordination and conducts assessments that include behavioral, clinical, social, and… more
- Blue KC (MO)
- …professional license in MO and KS required. + 5+ years of experience in integrated care , managed care , or population health program management. + 3+ years ... of progressive experience in population health, behavioral health integration, or managed care strategy within a payer or provider organization + Prior success… more
- CenterWell (Cheyenne, WY)
- …required. + Familiar with CAQH + Bilingual; English & Spanish + Experience in managed care or health care administration desired **Additional Information** + ... regarding own work approach/priorities, and follows direction. Work is managed and often guided by precedent and/or documented procedures/regulations/professional… more
- Highmark Health (Pittsburgh, PA)
- …thorough understanding of clinical reimbursement, federal and state regulations, and managed care issues. Identifies opportunities to optimize clinical ... trends, policies, and issues affecting physician practices. + Familiarity with risk, managed care , capitation, ACO development, and population health management.… more
- Penn Medicine (Plainsboro, NJ)
- …cards. Update/ enter e-MDs demographic information. + Collect appropriate co-payments for managed care members, post payment and issue receipt. + Collect ... medical records and correspondence as needed. + Maintain knowledge of managed care and third-party billing requirements relative to front desk processes,… more