- Integra Partners (Troy, MI)
- …compliance, regulatory affairs, and/or utilization management within a health plan or managed care environment + Demonstrated expertise in CMS and state ... The Medical Policy & Compliance Specialist is responsible for researching, analyzing, and interpreting...Medicaid, and NCQA regulations relevant to Utilization Management (UM), Credentialing and Claims, with the ability to translated them… more
- Tenet Healthcare (Detroit, MI)
- …equivalent education/training strongly preferred. 2. Two years of medical affairs office or credentialing experience in managed care , hospital, or physician ... Credentials Specialist Full Time Days - 2506001048 Description :...Detroit Medical Center (DMC) is a nationally recognized health care system that serves patients and families throughout Michigan… more
- HCA Healthcare (Richmond, VA)
- …to the Provider Enrollment Account Management team or Strategic Pricing and Analytics (SPA) Managed Care Team for resolution. We are an amazing team that works ... hours volunteering in our communities. As a Provider Enrollment Specialist with Parallon you can be a part of...of related experience preferred, such as Medicare/Medicaid Enrollment or Managed Care Enrollment + Relevant education may… more
- Ochsner Health (New Orleans, LA)
- …executive leadership team. Additionally, this job coordinates physician quality information and managed care audits and manages documentation and maintenance of ... and/or medical staff office experience **Certifications** Preferred- Certified Provider Credentialing Specialist and/or Certified Professional Medical Services… 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: Jul...required for revenue management report generation, and assist with credentialing management and regulatory audits. Duties/Responsibilities: + Promote revenue… more
- Dignity Health (Bakersfield, CA)
- …DMHC, NCQA, CMS and other regulatory bodies preferred. - Knowledge of HIPPA, managed care environment preferred. - Strong technical proficiency in data analysis; ... care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals,… more
- CommonSpirit Health Mountain Region (Colorado Springs, CO)
- …cooperation with emergency department personnel, psychiatrists, clinicians, attending physicians and managed care representatives. While in this position you ... something we value even more. As a Crisis Assessment Specialist you will be responsible for assessment of clients...Credentialing Center (ANCC) for superior quality in nursing care . With more than 300 days of annual sunshine,… more
- Communities Connected for Kids (Port Saint Lucie, FL)
- **Description** **_**This is a field-based foster care case management role that will travel and provide coverage to clients throughout Indian River, Martin, ... independent living for teens aging out of the foster care system? Would you like to assist adults formerly...and compassionate individual to be a Road to Success Specialist ! **Being a Road to Success Specialist … more
- CommonSpirit Health Mountain Region (Colorado Springs, CO)
- …cooperation with emergency department personnel, psychiatrists, clinicians, attending physicians and managed care representatives. While in this position you ... something we value even more. As a Crisis Assessment Specialist you will be responsible for assessment of clients...Credentialing Center (ANCC) for superior quality in nursing care . With more than 300 days of annual sunshine,… more
- Intermountain Health (Phoenix, AZ)
- …an entire market. Ensures enrollment is completed timely and accurately. Follows-up with managed care organizations and government payers to ensure timely and ... Staff, Medical Directors, and Administration. The position directs the on-going credentialing / privileging process and other administrative functions for the… more