• Manager, Care Management

    Humana (Lansing, MI)
    …Qualifications** + Certified Case Manager (CCM) + Previous experience working in a managed care field + 5 or more years of previous management/supervisor ... community and help us put health first** The Manager, Care Management leads teams of nurses and behavior health...and tools for teams to ensure compliance with state contract on performance metrics and to ensure member needs… more
    Humana (06/28/25)
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  • Manager I Care Management Team (DSS Region…

    Elevance Health (Wilkesboro, NC)
    …+ Service delivery coordination, discharge planning or behavioral health experience in a managed care setting preferred. **We are unable to accommodate LCSW-A, ... welfare system so that they receive seamless, integrated, and coordinated health care . Within the Children and Families Specialty Plan (CFSP), and regardless of… more
    Elevance Health (07/18/25)
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  • Reimbursement Specialist I - Home Care

    Rady Children's Hospital San Diego (San Diego, CA)
    …for billing and collections of outstanding account balances for commercial, government, and managed care payors as assigned. The Reimbursement Specialist I is ... for the Reimbursement Specialist I to read, interpret and apply complex payor contract language to expected reimbursement calculations and pursue all payments due to… more
    Rady Children's Hospital San Diego (07/24/25)
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  • Senior Customer Care Supervisor

    Mass Markets (Killeen, TX)
    …REQUIRED QUALIFICATIONS + Minimum of 3-yearscall center managementexperience + Associate 's degree or equivalent combination of education and relevant work ... applicant on the basis of age, ancestry, color, family or medical care leave, gender identity or expression, genetic information, marital status, medical condition,… more
    Mass Markets (07/11/25)
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  • Specialty Sales Representative, Immunology - Grand…

    Grifols Shared Services North America, Inc (Flint, MI)
    … strategy, and represent needs of the customer + Remain cognizant of managed care coverage throughout the business territory including major accounts and ... to respond to business customers, business and environmental needs of Marketing, Managed Markets, Operations, CL&D, and Medical Affairs. The SSR will also be… more
    Grifols Shared Services North America, Inc (07/22/25)
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  • Specialty Sales Representative, Immunology

    Grifols Shared Services North America, Inc (Albany, NY)
    contract strategy, and represent needs of the customer. *Remain cognizant of managed care coverage throughout the business territory including major accounts ... approach to respond to business customers. The SSR will liaise with Marketing, Managed Markets, Operations, CL&D, Medical Affairs and Telesales to achieve the goals… more
    Grifols Shared Services North America, Inc (07/20/25)
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  • Senior Compliance Specialist (Charlotte, NC)

    Compass Group, North America (Charlotte, NC)
    …industries, and of course we support Compass Group-- which is the world's largest contract food and support services provider. Why Foodbuy? We care about our ... the operational integrity and profitability of contracted programs utilizing a managed order guide for assigned distribution centers. Responsibilities:* Review … more
    Compass Group, North America (07/11/25)
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  • Director of Provider Services - Medicaid

    Humana (Raleigh, NC)
    …systems, and practice transformation. + Ensure team's compliance North Carolina's Managed Care Contractual requirements for provider relations, such as ... development for direct and indirect reports to drive exceptional associate engagement and performance + Set and monitor team...7+ years of management experience. + Working knowledge of managed care health plan and provider operations… more
    Humana (07/10/25)
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  • Provider Contracts Specialist

    Molina Healthcare (Long Beach, CA)
    …in the health care field including, but not limited to, provider's office, managed care organization, or other health care field. **PREFERRED EDUCATION** ... or an equivalent combination of education and experience **PREFERRED EXPERIENCE** : 1-3 Years Managed Care experience To all current Molina employees: If you are… more
    Molina Healthcare (07/25/25)
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  • Provider Network Account Executive II

    AmeriHealth Caritas (Fayetteville, NC)
    care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral ... access to services, maintaining financial integrity, and adhering to contract management requirements. ; **Work Arrangement:** + Remote -...+ 5 to 10 years of experience in the managed care /health insurance industry, with strengths in… more
    AmeriHealth Caritas (06/25/25)
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