- Vanderbilt University Medical Center (Nashville, TN)
- …pricing for emerging therapies and new service lines, while also working closely with Managed Care , Compliance, Finance, and Revenue Cycle teams to align pricing ... deliverables, including machine-readable files and shoppable services lists. + Collaborate with managed care and legal teams to respond to external pricing… more
- Whidbey General Hospital (Coupeville, WA)
- …Conditions of Participation regarding Utilization Review and Discharge Planning. The RN - Care Manager will lead an assessment to identify the patient's clinical ... throughput and assure that the organization and the patient's care are managed in the most efficient...other utilization mangement concerns to Physician Advisor or designated leader , as appropriate. Assists with discharge appeal process, as… more
- Takeda Pharmaceuticals (FL)
- …national level. + Use available tools and resources to monitor and evaluate industry/ managed care trends and communicate relevant information to those who are ... selling opportunities and adaptability to changing market conditions + Understanding of managed care landscape and how it influences/impacts business + Strong… more
- UCLA Health (Los Angeles, CA)
- …related field required + Minimum of five years' experience in a Medicare or Managed Care environment managing enrollment, claims or encounters required + Minimum ... data analysis and reporting to support operational decisions + Lead and support audits, quality control initiatives, and performance...years' experience with CMS processes in a Medicare or Managed Care environment required + Experience with… more
- Banner Health (AZ)
- …Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options ... Banner Health the best place to work and receive care . This is a very self- managed team...experience and expertise in support of a nationally-recognized healthcare leader . We offer stimulating and rewarding careers in a… more
- Blue KC (KS)
- …work/projects + Excellent verbal and written communication skills + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid ... Medical and Pharmacy Management Committee). + Improves the quality and efficiency of care in the network and integrate providers into BlueKC clinical initiatives by… more
- J&J Family of Companies (San Francisco, CA)
- …to address critical access and affordability issues for patients. . Partner with managed care colleagues to understand current policies and potential future ... (FRM) is responsible for serving as the primary field-based lead for education, assistance, and issue resolution with healthcare...across multiple payer types and plans (ie, Medicare, Medicaid Managed Care , Commercial). . Execute business in… more
- Prime Healthcare (Kansas City, MO)
- …Resolution is the lead responsible for the timely follow-up of Managed Care /Commercial accounts. Communicates clearly and efficiently by phone with health ... and reports. Responsible to obtain State collection guidelines if applicable. Reviews managed care contracts. Qualifications Education and Work Experience +… more
- Trinity Health (Des Moines, IA)
- …of applications for provider enrollment for Medicare, Railroad Medicare, BCBS, Medicaid, Managed Care payers, and applicable Commercial payers in a timely ... directory of providers NPI log in and password. Complete Managed Care checklist. Supplies accurate and timely...and perceiving our world and that these differences often lead to innovative solutions. Our dedication to diversity includes… more
- J&J Family of Companies (Seattle, WA)
- …to address critical access and affordability issues for patients + Partner with managed care colleagues to understand current policies and potential future ... (FRM) is responsible for serving as the primary field-based lead for education, assistance, and issue resolution with healthcare...across multiple payer types and plans (ie, Medicare, Medicaid Managed Care , Commercial). + Execute business in… more