- Novant Health (Charlotte, NC)
- …Payor Strategy and Relationship Management is a professional advisor supporting managed care contracts with health plans, payors, employer groups and ... consultants, and executive level staff to answer internal operations management questions about managed care ...trends. **This is a Remote Position Responsibilities + Commercial Managed Care Payor Contract Negotiations… more
- ERP International (Nellis AFB, NV)
- …Call, No Weekends, No Holidays! **Job Specific Position Duties:** * Knowledge of managed care principles, military and civilian population healthcare, case ... of selected diseases. * Collaborates with case manager, utilization manager, and Managed Care Support Contractor to identify patients appropriate for each… more
- Humana (Springfield, IL)
- …long-term care services, Home and Community-Based Services (HCBS), and/or managed care organizations. + Intermediate to advanced computer skills and ... care as appropriate and required by our comprehensive contract . **Use your skills to make an impact** **Required...One (1) or more years of experience in health care and/or case management . + One (1)… more
- Catholic Health Initiatives (Omaha, NE)
- …development and management of patient-centered quality initiatives with CVSL Executive Managed Market Director; and, in conjunction with the SSVP of the PE, and ... national best practices. + Works (in partnership with Executive Managed Market Director and CHI Health leadership) to build...improve the patient experience for those patients in the care of the CVSL based on opportunities identified through… more
- Rush University Medical Center (Chicago, IL)
- …format which is specific to the patient/family learning abilities and language preference. * Identifies care management contract outcomes by using care ... the health care team to facilitate effective care management and support services at the... managed care in a health care setting preferred. * Case Management certification… more
- Elevance Health (Atlanta, GA)
- …of experience with complex psychiatric/substance abuse cases required. + Prior managed care experience required. **Preferred Skills, Capabilities, and ... + Behavioral Health and/or substance abuse experience strongly preferred. + Previous managed care experience preferred. + MCG and ASAM experience strongly… more
- The Cigna Group (Los Angeles, CA)
- …in lieu of a bachelor's degree.** MBA or MHA preferred. + **3+ years Managed Care contracting and negotiating experience involving complex delivery systems and ... relationships with provider partners. + Intimate understanding and experience with hospital, managed care , and provider business models. + Team player with… more
- Dignity Health (Bakersfield, CA)
- …Delegation Management Specialist will possess extensive experience in healthcare compliance, contract management , and delegation management . Will act as ... and other regulatory bodies preferred. - Knowledge of HIPPA, managed care environment preferred. - Strong technical...the effort in developing Dignity Health's Medicaid population health care management pathways. Dignity Health MSO is… more
- Intermountain Health (Salem, OR)
- … care management /navigation or closely related field including Utilization Management , discharge planning, managed care , health promotion, health ... assistance and enrolls and follows these members in longitudinal care management services. + Follows the applicable...and consistent with goals and objectives of referral, payer contract , or established care processes. + Maintains… more
- Valor Health (Altus, OK)
- …the VA and works with these patients utilizing rules set forth by the VA for co- managed care . + Completes any and all clinical reminders "due" at the time of ... internal organ systems and delivers preventive and therapeutic treatment of primary care needs, including chronic disease management , of patients through routine… more