- UCLA Health (Los Angeles, CA)
- …improvement. This position calls for a strong foundation in CMS guidelines, managed care compliance, and effective collaboration with both internal teams ... 5 or more years of experience in Medicare Advantage or Part D Managed Care environment. + Hands-on experience conducting and leading RADV audits, highly desired.… more
- Prime Healthcare (Evanston, IL)
- …of Discharge Planning/ Utilization Management / Case Management terminology and functions, in both managed care and non- managed care environments. 2. ... Experience in basic to intermediate computer skills/knowledge 3. Current BCLS (AHA) certificate required upon hire and maintain current. Facility Specific Requirements (facility may require items listed below): + RN license upon hire preferred + LVN license… more
- UTMB Health (Huntsville, TX)
- …**New** Social Service UTMB Health Requisition # 2506981 The mission of Correctional Managed Care is to address the healthcare needs of underserved patient ... **:** + Contributes to the success of the UTMB Correctional Managed Care operation. + Provides clinical and administrative supervision of mental health… more
- Ascendis Pharma (Princeton, NJ)
- …administration of rebate programs, including government rebates (eg, Medicaid, Medicare), managed care rebates, and commercial rebates. Ensure accurate ... processes accurately and before payment deadlines, oversee payments of managed care and government rebates, and manage Market Access payments including… more
- Insight Global (Montgomery, AL)
- …a Senior Professional Business Analyst to support client delivery initiatives within the managed care space. This role requires expertise in prior authorization ... Skills and Requirements Proven experience as a Business Analyst in managed care or healthcare environments. Strong understanding of prior… more
- Publicis Groupe (Morristown, NJ)
- …strategies that help our pharmaceutical clients succeed in today's complex and dynamic managed care marketplace. Our approach yields insight into actual payer ... knows how to rock in a hard space. Since day one, Payer Sciences has approached managed markets from a different angle. We firmly believe the truth lies in the data.… more
- Molina Healthcare (Columbus, OH)
- …Quality/HEDIS for Medicaid, Marketplace and Medicare/MMP. + Analysis and reporting related to Managed care data like Medical Claims, Pharmacy, Lab and HEDIS ... scrapping, and cleaning of data. + 5+ Years of experience in Managed Care Organization executing similar techno functional role that involves writing complex SQL… more
- Lundbeck (New Orleans, LA)
- …and/or experience in other areas of the business; ie, marketing, sales training, managed care account manager, sales operations, account management is a plus. ... the Business + Guides the identification of local market systems of care , patient flow, reimbursement, and provides innovation solutions + Identifies strategic… more
- UTMB Health (Huntsville, TX)
- …Crafts, Trades & Labor UTMB Health Requisition # 2504558 The mission of Correctional Managed Care is to address the healthcare needs of underserved patient ... Provides for the routine operation and minor maintenance of Correctional Managed Care vehicles in the transportation of materials or passengers. **_ESSENTIAL JOB… more
- PruittHealth (Norcross, GA)
- …timeliest manner. 7. Applies knowledge of specific payer billing/payment rules, managed care contracts, reimbursement schedules, eligible provider information ... governmental programs, regulations and billing processes, commercial third-party payers, and/or managed care contracts and coordination of benefits * Familiarity… more