• Sr. Consultant, Tech - Global Pricing…

    IQVIA (New Providence, NJ)
    …(eg, Medicaid, Master Data Management, Chargebacks, Government Pricing, Testing, Managed Care Contracting, Commercial Contracting, Integration Development, ... * Master Data Management * Chargebacks * Government Pricing * Testing * Managed Care Contracting * Commercial Contracting * Integration Development * Report… more
    IQVIA (11/20/25)
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  • Senior Medical Management Nurse - VCHCP

    Ventura County (Ventura, CA)
    …compliance with applicable criteria, medical policies, member eligibility benefits, contracts and industry standards/guidelines; + Performs telephonic care /case ... and accurately applying regulatory requirements of the Department of Managed Health Care (DMHC) and standards; +...Care Plan. + Experience working as a case manager in a health plan case managing complex cases.… more
    Ventura County (12/07/25)
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  • Utilization Management Coordinator

    Saint Francis Health System (Tulsa, OK)
    …accreditation for Laureate and/or to maintain the delegation standards established by the managed care contracts . Investigates and prepares appeals for ... health care , part of which may be experience in Behavioral health managed care . Knowledge, Skills and Abilities: Working knowledge of Microsoft Word, Excel… more
    Saint Francis Health System (11/14/25)
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  • Utilization Review Specialist Nurse (RN) | Case…

    Houston Methodist (Houston, TX)
    …services by communicating medical information required by all external review entities, managed care contracts , insurers, fiscal intermediaries, state, and ... national coverage determinations + Comprehensive knowledge of Medicare, Medicaid, and Managed Care requirements + Comprehensive knowledge of community resources,… more
    Houston Methodist (11/02/25)
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  • Verification Specialist - PMPH

    Penn Medicine (Plainsboro, NJ)
    …significant knowledge of all types in-network and out-of-network health insurance, managed care companies, benefits and policies for commercial, Medicare ... regulations and requirements + Ability to develop a good working relationship with managed care organizations, and provide excellent customer service + Ability… more
    Penn Medicine (12/03/25)
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  • Provider Engagement Professional

    Humana (Frankfort, KY)
    …Medicaid policies, processes, and procedures. + Understanding of Kentucky managed care contracts , including contract language and reimbursement. + ... and trainings and education. + Serves as primary relationship manager with physicial health and behavioral health providers to...locations.** + Bachelor's Degree. + 2+ years of health care or managed care experience… more
    Humana (12/04/25)
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  • Research Financial Administrator Associate

    University of Michigan (Ann Arbor, MI)
    …sponsor and institutional policies, or donor intent; establishing and monitoring sub- contract awards and sub- contracts to other institutions; advising ... patients, populations and communities through excellence in education, patient care , community service, research and technology development, and through leadership… more
    University of Michigan (12/06/25)
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  • Director, Finance for a Clinical Department

    University of Maryland, Baltimore (Baltimore, MD)
    …members. Oversee management of complex funding and service agreements, patient billing and managed care contracts . Review, analyze and interpret all ... * Direct the management of complex funding and service agreements, patient billing and managed care contracts . Review, analyze and interpret all financial… more
    University of Maryland, Baltimore (11/15/25)
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  • Internal Control Officer, WCB item

    New York State Civil Service (Schenectady, NY)
    …Attend quarterly meetings with the Office of Language Access.* Procurement and Contract Management: Work with agency Procurement team to ensure the necessary ... contracts and purchase orders are in place to use...hybrid telecommuting schedule can be discussed with the hiring manager during the interview.We offer a work-life balance and… more
    New York State Civil Service (12/06/25)
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  • System Configuration Coordinator - Remote

    Dragonfly Health (AZ)
    …obtained through work experience, education or training * Durable medical equipment, pharmacy, managed care , or other pertinent health care services industry ... to boost operational efficiencies, contain costs, enhance quality of care , and ultimately increase patient satisfaction. With our innovative technology… more
    Dragonfly Health (12/02/25)
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