- Northern Light Health (Bangor, ME)
- …strong verbal and written communication skills as it relates to coordination of care , case presentations and clinical documentation. + Understand and value ... Services Clinician models a multi-disciplinary approach to providing quality patient care as defined in the Acadia Hospital/Acadia Healthcare policy and procedure… more
- Rush University Medical Center (Chicago, IL)
- …experience * Experience within a hospital or clinic environment, a health insurance company, managed care organization or other health care financial service ... Medicaid, Social Security Disability, Champus, Supplemental Security Income Disability, etc., managed care contracts and coordination of benefits is highly… more
- Rush University Medical Center (Oak Park, IL)
- …* Experience within a hospital or clinic environment, a health insurance company, managed care organization or other health care financial service ... Medicaid, Social Security Disability, Champus, Supplemental Security Income Disability, etc., managed care contracts and coordination of benefits is highly… more
- Sea Mar Community Health Centers (Kelso, WA)
- …Health Organization, County, and/or MCO contracts with the ability to tier clients in a managed care system. The ability to work effectively with all persons and ... recommendations. It is suggested that this individual communicate with the Primary Care Physicians, Substance Abuse Counselors, schools, case workers, or others… more
- Glengariff Rehabilitation and Healthcare Center (Glen Cove, NY)
- …with federal and state regulations and company policy and procedures. Acts as in-house case manager by considering all aspects of the residents care ... that govern the process + Acts as an in-house Case Manager demonstrating detailed knowledge of residents...of MDS requirements related to varied payers including Medicare, Managed Care and Medicaid + Ensures timely… more
- Fallon Health (Worcester, MA)
- …a company that cares. We prioritize our members-always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon ... Health delivers equitable, high-quality, coordinated care and is continually rated among the nation's top...summary of purpose** : Under the direction of the Manager of Prior Authorization, communicates with contracted and non-contracted… more
- Healthfirst (NY)
- …operational discipline and capacity for executive-level decision-making** + **Experience working as a case manager for a long-term care programs such as ... **Demonstrated understanding of UM regulatory requirements, clinical review process, and managed care operations** + **Work experience interpreting and… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …+ Minimum of 2-3 years' experience functioning as a clinical pharmacist in a managed care or hospital setting + Experience in direct supervision of technical ... about their medications, conditions, and pharmacy benefits to achieve optimal participant care outcomes. + Collaborate with Pharmacy Benefit Manager (PBM)… more
- Northwell Health (Staten Island, NY)
- …plan and makes all necessary referrals. Completes Discharge Summary at time of release.*3. Case Management*Functions as a case manager with overall ... program limits, as required.*Serves as primary contact to insurance carriers and managed care companies. Ensures patients are appropriately certified and assists… more
- The Cigna Group (Orlando, FL)
- …technology systems + Bilingual in Spanish or Haitian Creole preferred + Knowledge of managed care preferred If you will be working at home occasionally or ... support. + Facilitate critical incident response by consulting with requesting manager and direct service providers to arrange appropriate clinical services,… more