- Beth Israel Lahey Health (Peabody, MA)
- …payment plans, pricing estimates, Financial Assistance, Federal/State benefits, and the managed care process. This position supports Patient Access and ... Open Enrollment; providing education and processing necessary applications. + Addresses Managed Care concerns with patients who require assistance. +… more
- Molina Healthcare (AZ)
- …experience, and at least 2 years as a medical director in managed care setting supporting utilization management/quality management initiatives, or equivalent ... to members - ensuring members receive the most appropriate care in the most effective setting. Contributes to overarching...(CPHM), Certified Professional in Healthcare Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case … more
- University of Southern California (Alhambra, CA)
- …and approval. Applies proficiency in understanding and applying contractual terms of our Managed Care contracts (ie, PPO, HMO, EPO, POS, Medi-Cal, Medicare, ... as needed. Communicates identified billing issues and trends to Supervisor and Billing Manager in a timely manner. Communicates issues with claim scrubber edits to… more
- Sevita (AL)
- …government authorities and referral agencies such as counties, regional centers, managed care contractors, and government administrators. 3. Related ... works with the Quality Improvement Director and directs the Quality Improvement Manager in developing and implementing state strategies to manage and improve… more
- Covenant Health Inc. (Knoxville, TN)
- …self-development. + Stays abreast of regulatory changes issued by Medicare, TennCare, managed care payers and agencies and communicates updates to staff ... Overview Manager of Surgery Administration & Business Operations Full...clinical expertise with advanced medical technology to deliver exceptional care . As a Joint Commission Comprehensive Stroke Center, we… more
- Allaire Rehab & Nursing (Freehold, NJ)
- …in a timely manner after a referral is given by a hospital discharge planner, case manager , social worker, physician, or family member. Note: Timely refers to ... a working knowledge of Federal and State regulations and reimbursement ( Managed Care , Medicare, and Medicaid). + Provide assistance with new Stakeholder… more
- Rush University Medical Center (Chicago, 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)
- …plans, and leads groups. The Licensed Mental Health Therapist provides therapy to managed care patients that are pre-authorized to receive mental health ... Health Therapist Licensed (MHTL) provides individual and group counseling, case management, crisis stabilization, suicide risk assessment, and treatment planning.… more
- Molina Healthcare (Bowling Green, KY)
- …(CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of America ... new programs. Preferred Qualifications * Experience with utilization/quality program management. * Managed care experience. * Peer review experience. * Certified… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …and Off Marketplace health insurance products, including Child Health Plus (CHP), Medicaid Managed Care (MA/MMC), Essential Plan (EP) and the Individual Market - ... through home visits and outreach. * Educates and assists members with accessing care , Case Management program and benefits and government cell phone programs.… more