- Elevance Health (Tampa, FL)
- …or related field and a minimum of 7 years experience in broad-based analytical, managed care payor or provider environment as well as in depth experience ... Provides the highest level of analytical support to the Cost of Care and/or Provider Contracting organizations. Focuses efforts on lowering claims costs, improving… more
- Chenega Corporation (Rockville, MD)
- …and Task specific knowledge of worker's compensation, injury compensation programs, or managed care . + Professional Background: Relevant experience in claims ... Strategic Business Unit** company, is looking for a Nurse Practitioner- Contract Medical Reviewer (CMR) to support the Department of...project team as directed. + Support the CSCS Program Manager and Project Manager 's efforts to provide… more
- AdventHealth (Maitland, FL)
- …strong organizational skills. The Medical Economics Manager will manage and mentor managed care staff for both the Florida and Multi-State Divisions of ... care contracts, proposals, analyze fee schedules, and determine contract compliance. The Medical Economics Manager must...that achieve net revenue targets developed by the Regional Managed Care Directors and Contract … more
- The Cigna Group (Atlanta, GA)
- …+ Intimate understanding and experience with larger, more complex integrated delivery systems, managed care , and provider business models + Team player with ... Proficient in contract building software such as Contract Manager If you will be working...of life. We guide our customers through the health care system, empowering them with the information and insight… more
- The Cigna Group (Mclean, VA)
- …Experience in developing and managing relationships + Understanding and experience with hospital, managed care , and provider business models a plus + Team player ... the Provider Contracting Team and reports to the Contracting Manager or Market Lead. This role assists and supports...and projects financial impact of provider contracts and alternate contract terms. + Creates "HCP" agreements that meet internal… more
- UPMC (Pittsburgh, PA)
- UPMC Community Care Behavioral Health is hiring a full-time Precert Care Manager . This role will work Monday - Friday 3:30 pm - midnight with rotating ... reside within Pennsylvania or the tri-state area. A Precert Care Manager for the 24 hour precert...specific clinical interventions and coordinates with the assigned Community Care contract and care management… more
- Rush University Medical Center (Chicago, IL)
- …may vary depending on the circumstances of each case. **Summary:** The Social Work Care Manager I is an Illinois licensed social worker who provides patient ... care coordinator, and advocate. The Social Work Care Manager I collaborates with other members...Experience utilizing motivational interviewing preferred. * Experience working with managed care in a health care… more
- Huron Consulting Group (Chicago, IL)
- …pressure to improve clinical outcomes and reduce the cost of providing patient care . Investing in new partnerships, clinical services and technology is not enough to ... internal processes and deliver better consumer outcomes. The Vendor Management Manager provides management of standardized vendor processes to support Huron … more
- Humana (Richmond, VA)
- …(2) years of MCO management/supervisory experience. + Understanding of the Cardinal Care Contract + Experience serving Medicaid, Medicaid/Medicare, TANF, and/or ... first** Humana Healthy Horizons in Virginia is seeking a Manager , Care Management (Maternal-Child Health) who will...management/leadership experience + Previous direct experience working in a managed care field. + 5 or more… more
- Molina Healthcare (Rockwell City, IA)
- …until they are discharged from your service. The ideal candidate will have experience as a Care Manager within a managed care organization (MCO) like ... JOB DESCRIPTION Opportunity for an experienced Care Manager to join the LTSS...licensure and/or certification required ONLY if required by state contract , regulation or state board licensing mandates. If licensed,… more
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