- 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 ... of services provided to members - ensuring members receive the most appropriate care in the most effective setting. Contributes to overarching strategy to provide… more
- Abbott (Abbott Park, IL)
- …and implementing pricing strategies across all ADC brands and customer channels, including Managed Care , Medicaid, Medicare, Retail, and Point of Care ... you can do work that matters, grow, and learn, care for yourself and your family, be your true...and risks for pricing strategy development + Collaborate with Contracting Teams to provide input into contract development, administration,… more
- Centene Corporation (Sacramento, CA)
- …Bachelor's degree in related field or equivalent experience. Two years of managed care or medical group experience, provider relations, quality improvement, ... relations to ensure delivery of the highest level of care to our members. Engage with providers to align...claims, contracting utilization management, or clinical operations. Project management experience… more
- Centene Corporation (Tallahassee, FL)
- …Bachelor's degree in related field or equivalent experience. Two years of managed care or medical group experience, provider relations, quality improvement, ... relations to ensure delivery of the highest level of care to our members. Engage with providers to align...claims, contracting utilization management, or clinical operations. Project management experience… more
- Trinity Health (Grand Rapids, MI)
- …operational initiatives including new services/programs, revenue enhancement, expense reduction, managed care utilization systems, and strategies. Responsible ... people, processes and / or programs that support direct or indirect patient care . Promotes and advocates for patients, pharmacists / colleagues and the practice of… more
- Seattle Children's (Seattle, WA)
- …claims processing role. Technical understanding of CMS and/or Commercial/Medicaid or Managed Care Insurance billing regulations. **Required Credentials** N/A. ... out of region payors. This role collaborates with the Complex Authorization Team, Contracting and Payer Relations and our medical partners (SCCA, UWP, UWMC), and… more
- Fallon Health (Worcester, MA)
- …**Experience:** 4 plus years' experience in an office environment, preferably in health care and/or managed care system Strong analytical and problem-solving ... a company that cares. We prioritize our members-always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon… more
- CVS Health (Harrisburg, PA)
- …Qualifications** + Experience supervising or managing crisis services. + Background in managed care and behavioral health program development. + Familiarity with ... value-based care models and provider contracting . **Education & Licensure** + Master's degree in Behavioral Health field. + Active clinical license required… more
- Cedars-Sinai (Beverly Hills, CA)
- …and designated Research Grant Specialist to ensure all grant awards are appropriately managed and maintained for Faculty holding a primary appointment in the area. + ... Responsible for facilitating the Faculty contracting process in coordination with Academic Human Resources. +...voucher distribution and use, and all expenditures for patient care expenses and equipment purchases. + Responsible for yearly… more
- Dignity Health (Bakersfield, CA)
- …care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, ... records updating existing provider records and working with the Contracting and Credentialing teams as needed when questions arise....with a business objective to excel in coordinating patient care in a manner that supports containing costs while… more