- ZOLL Medical Corporation (Orlando, FL)
- …+ Experience working with VA hospitals and the VA System and or large managed care organizations (ie, Kaiser, WellStar) preferred. + Two years minimum of ... multi-task and prioritize work. + Familiarity with clinical reimbursement, and managed care policies and procedures is highly desirable. + Above average… more
- CVS Health (Annapolis, MD)
- …State Medicaid regulations and billing guidelines + CMS requirements and Federal managed care rules + Timelyfilinglaws and encounter data reporting requirements ... limited to the description above. **Preferred Qualifications** + Experience with Medicaid managed care organizations (MCOs) or state Medicaid agencies. +… more
- Prime Therapeutics (Providence, RI)
- …is located + 3 years of relevant work experience in a retail, hospital, clinical and/or managed care setting, including at least 2 years of work experience in a ... clinical and/or managed care setting Must be eligible to work in the United States without the need for work visa or residency sponsorship **Additional… more
- Sutter Health (Modesto, CA)
- …base of health care delivery and case management within a managed care environment. Comprehensive knowledge of laws, regulations and professional standards ... benchmarking and outcomes measurements preferred. PC skills, word processing, spreadsheets and managed care software programs. Adheres to Sutter Health policies… more
- Sodus Rehab & Nursing Center (Tarrytown, NY)
- …& paperwork requirements + Maintain knowledge of regulations governing Medicare/Medicaid/ Managed Care reimbursement processes + Coordinate and implement ... + Maintain knowledge of Federal and State regulations and reimbursement processes ( Managed Care , Medicare, and Medicaid). + Effectively manage budgeted occupancy… more
- Humana (Lincoln, NE)
- …management, or similar activities **Preferred Qualifications:** + Knowledge of the managed care industry, Integrated Delivery Systems, health insurance, or ... staff to provide Humana members with optimal value based care in accordance with Medicare and Humana policy. All...a medical management review organization such as Medicare Advantage, managed Medicaid, or Commercial health insurance + Current and… more
- The Hartford (Hartford, CT)
- …clinic/facility + Case management and discharge planning experience preferred + Managed care /utilization review experience preferred + Crisis intervention skills ... the medical treatment to ensure quality, effective, and cost-efficient care . Conducts comprehensive evaluations of disability claimants' functionality via functional… more
- Healthfirst (NY)
- …RN Demonstrated understanding of UM regulatory requirements, clinical review process, and managed care operations Leadership experience in managing, coaching and ... environment Understanding of health plans such as Medicare, Medicaid and//or Managed Long-Term Care Plan (MLTCP) Experience working as a case manager for a… more
- Sharp HealthCare (San Diego, CA)
- …years' experience as a practicing primary care physician with knowledge of managed care and the process for prior authorization review. + California ... and Abilities** + Knowledge of physician social and political behavior and managed care philosophy. + Demonstrate effective communication skills, ability to… more
- Union Hospital Health Group (Terre Haute, IN)
- …Specialist Details Essential Job Duties: + Credentialing/re-credentialing applications for managed care organizations and hospitals + Maintaining provider ... + Assisting with revenue cycle duties and analysis + Performing other managed care tasks as assigned Education, Training & Experience + High School diploma… more