- Mount Sinai Health System (New York, NY)
- …sets, Epic edits, and reimbursement. + Capacity to review, analyze and interpret managed care contracts, billing guidelines, and state and federal regulations ... ensure they align with payer regulations, Medicare/Medicaid reimbursement methodologies, and managed care contracts. + Provides routine, standardized reporting… more
- Providence (Eureka, CA)
- …them. **Required qualifications:** + 1 year Experience working with physicians in a managed care /IPA, Medical group, health plan or MSO environment with Provider ... + Bachelor's Degree in Healthcare Management. + 2 years Managed care Provider Relations experience. **Why Join Providence?** Our best-in-class benefits… more
- Logan Health (Kalispell, MT)
- …Preferred Qualifications: + Associate's or Bachelor's degree. + Experience with managed care coverage, reimbursement, medical terminology, and medical coding. ... + Strong working knowledge of applicable rules, regulations and guidelines governing managed care coverage and reimbursement preferred. + Background knowledge… more
- Penn Medicine (Lancaster, PA)
- …referrals. Communication may be via fax telephone electronically. + Review and analyze managed care patient visits and ensure proper documentation of required ... services. + Coordinate internal functions and recordkeeping related to managed care organizations to meet compliance. + In collaboration with staff in LG Patient… more
- Outreach Development Corporation (Brentwood, 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
- Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
- …manner. + Concurrent Stay Reviews: Conduct concurrent and extended stay reviews for both managed care cases and Kepro counites in a timely manner to ensure ... and third-party reimbursement + Two or more years' experience working in managed care environment + Ability to apply and interpret admission and continued stay… more
- Penn Medicine (Princeton, NJ)
- …assessment and evaluation of patients seeking psychiatric/behavioral healthcare in a managed care environment. Demonstrates competency in assessing children, ... Demonstrates competency with suicide risk assessments and crisis intervention. Works with managed care companies to determine level of care needed by… more
- Walmart (Bentonville, AR)
- …accounting, economics, or related area with 7 years' experience in managed care contracting/negotiations, healthcare billing, healthcare finance, or healthcare ... compliance/legal; or Ten years of relevant experience in managed care contracting/negotiations, healthcare billing, healthcare finance, or healthcare… more
- CVS Health (Northbrook, IL)
- …success in driving sophisticated contract negotiations and completion of contracts, PBM and managed care expertise, with a focus on the management of pharmacy ... **Required Qualifications:** -10+ years of professional work experience in healthcare, managed care , health plans, or PBM, preferably with a focus on financial… more
- Healthfirst (NY)
- …Demonstrated understanding of UM regulatory requirements, clinical review process, and managed care operations + Work experience interpreting and ... + Deliver on Healthfirsts Mission by ensuring optimum quality of member care in a cost-effective manner + Ensure UM operations meet regulatory requirements… more
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