- Hartford HealthCare (Hartford, CT)
- …**Organization:** **Hartford HealthCare Corp.* **Title:** *Sr Payer Analyst / Managed Care Contracting* **Location:** *Connecticut-Hartford-100 Pearl Street ... the system. *_Position Summary:_* Reporting directly to the Manager of Payer Contract Analytics, the Sr. Payer Analyst is responsible for payer contracting analytics… more
- Cedars-Sinai (CA)
- …Los Angeles and beyond. **Req ID** : 11588 **Working Title** : Claims Examiner - Managed Care **Department** : MNS Managed Care **Business Entity** ... and adjusts data, determines appropriate codes, fees and ensures timely filing and contract rates are applied. + Responds and documents resolution of inquiries from… more
- Molina Healthcare (Cambridge, MA)
- …experience **Required Experience** + Minimum of five (5) years' experience in a managed care environment (including Medicare, Medicaid and other State governed ... Medicare, Marketplace, and other government-sponsored programs to provide health care services to low income, uninsured, and other populations.… more
- CVS Health (Springfield, IL)
- …ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions ... heart, each and every day. **Position Summary** Join our team as an IT Managed Services Operations Manager, where you'll serve as the Managed Services Statement… more
- PVH Corp. (Bridgewater, NJ)
- …Operations department. Operations & Service Management is responsible for **Application Managed Services (L2)** , Enterprise Operations Center including L2 for ... and Global Service Desk & Service Management. As part of the Application Managed Services, the team will establish a world-class Application Managed Services… more
- HCA Healthcare (Nashville, TN)
- …for clinical and non-clinical audiences + Comprehensive knowledge of formulary managed care systems, principles and practices **What qualifications you ... auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. + Free counseling… more
- InGenesis (Columbia, SC)
- InGenesis is currently seeking a Registered Nurse / RN - Managed Care Coordinator to work for our client located in Columbia, SC. In this role you will review ... of clinical information to support and determine medical necessity criteria and contract benefits. * Utilize allocated resources to back up review determinations. *… more
- Henry Ford Health System (Detroit, MI)
- …to ensure value-based revenues are accurately modeled and recorded. + Partner with Managed Care Contracting to ensure contract terms, reimbursement ... team structures, improve upstream processes in collaboration with Revenue Cycle, Finance, Managed Care , System Analytics, and the Mosaic CIN. This leader plays a… more
- US Tech Solutions (Columbia, SC)
- **Location: Columbia, SC 29229 (Remote after training)** **Duration: 3+ Months Contract (Possible Temp to Hire)** **Job Description:** + Must be an RN in SC and have ... plan, implement, health coach, coordinate, monitor, and evaluate medical necessity and/or care plan compliance, options, and services required to support members in… more
- WellSpan Health (York, PA)
- …recurrent authorizations are present to ensure timely reimbursement. Assists with coordination of care and/or transfers to higher levels of care . Refers patients ... completion and submission of applications for public assistance or uncompensated care . Provides support to multiple provider types in behavioral health authorization… more