- Houston Methodist (Houston, TX)
- …the designated area(s) of responsibility or populations served. The Pharmacy Clinical Specialist position supports the delivery of pharmacy managed protocols, ... At Houston Methodist, the Pharmacy Clinical Specialist position is responsible for performing advanced clinical pharmacy duties enabling the delivery of optimal… more
- East Boston Neighborhood Health Center (Revere, MA)
- …care preferred. EXPERIENCE: One to three year's experience working in a Medical Staff Office, Credentialing or Managed Care in a hospital, managed ... of our patients and communities. Whether you're a nurse or physician providing direct care , a manager leading dedicated teams, or part of the essential support staff… more
- Houston Methodist (The Woodlands, TX)
- …the designated area(s) of responsibility or populations served. The Pharmacy Clinical Specialist position supports the delivery of pharmacy managed protocols, ... At Houston Methodist, the Pharmacy Clinical Specialist position is responsible for performing advanced clinical pharmacy duties enabling the delivery of optimal… more
- MyFlorida (Pensacola, FL)
- …The Department of Children and Families and The Office of Children's Medical Services Managed Care Plan and Specialty Programs. The program offers home-based ... REGISTERED NURSE SPECIALIST - 64040063 Date: Dec 4, 2025 The...MFC RN will work in collaboration with the Medicaid Managed Care Plan, the Community Based Agency… more
- MyFlorida (Tallahassee, FL)
- …The Department of Children and Families and The Office of Children's Medical Services Managed Care Plan and Specialty Programs. The program offers home-based ... REGISTERED NURSE SPECIALIST - 64000663 Date: Nov 14, 2025 The...MFC RN will work in collaboration with the Medicaid Managed Care Plan, the Community Based Agency… more
- Access: Supports For Living (Middletown, NY)
- …portals. + Maintain a working knowledge of OMH, OASAS, Medicare, Medicaid, Medicaid Managed Care and other payers' billing regulations for all programs. + ... Senior Billing Specialist Location: Middletown, NY, United StatesDate Posted: Nov...required for revenue management report generation, and assist with credentialing management and regulatory audits. Duties/Responsibilities: + Promote revenue… more
- Banner Health (Phoenix, AZ)
- …proficient with commonly used office software. PREFERRED QUALIFICATIONS Previous knowledge of managed care concepts. Working knowledge of medical terminology and ... to achieve Magnet (TM) recognition by the American Nurses Credentialing Center. The Phoenix campus, long known for excellent...position must work with and understand the concepts of managed health care and be able to… more
- Molina Healthcare (San Antonio, TX)
- …in health care field including, but not limited to, provider's office, managed care , or other health care field. **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS ... contracting with large specialty or multispecialty provider groups. * 1-3 Years Managed Care experience **PREFERRED EXPERIENCE** : Knowledge of integrated… more
- Molina Healthcare (Tucson, AZ)
- …experience in quality management and clinical quality investigations, preferably in a managed care setting, or equivalent experience * Registered Nurse. License ... critical incident cases; review of medical record documentation for credentialing and model of care oversight; and...Health Quality (CPHQ). * Medical record abstraction experience. * Managed care experience. * Ability to work… more
- CareFirst (Baltimore, MD)
- …years experience in risk adjustment coding, ambulatory coding and/or CRC coding experience in managed care ; state or federal health care programs; or health ... in claims submissions. Utilizes coding expertise, combined with medical policy, credentialing , and contracting rules knowledge to build the effective guides and… more