- UCLA Health (Los Angeles, CA)
- …field required + Minimum of five (5) years' experience in a Medicare or Managed Care environment managing enrollment, claims or encounters required + Minimum of ... years' experience with CMS processes in a Medicare or Managed Care environment required + Experience with...and systems to improve efficiency. + Proven skills to lead and facilitate cross-functional workgroups and other meetings. +… more
- Trinity Health (Ann Arbor, MI)
- …four (4) years of nursing experience and two (2) years of charge audit, managed care or comparable patient payment processing experience preferred. Must have ... including government payers, applicable federal and state regulations, healthcare financing and managed care . Knowledge of and experience in case management and… more
- J&J Family of Companies (Nashville, TN)
- …to address critical access and affordability issues for patients. + Partner with managed care colleagues to understand current policies and potential future ... and affordability solutions across multiple payer types and plans (ie, Medicare, Medicaid Managed Care , Commercial). + Execute business in accordance with the… more
- Rochester Regional Health (Rochester, NY)
- …and huddles as appropriate; * Conduct pre-visit planning and post-visit follow-up for care managed patients; * Provide feedback to providers regarding patient ... Job Title: Ambulatory Care Manager Location: Wilson Multicultural Medical Campus -...lead and facilitate a team approach to population-based care + Critical thinking skills, decisive judgement + Exceptional… more
- Humana (Lansing, MI)
- …while providing clinical support for internal stakeholders. Utilizes broad understanding of managed care and PBM knowledge to develop, and/or implement ... cost trend and improve health outcomes. The Clinical Pharmacist Lead works on problems of diverse scope and complexity...health plan. The individual leverages a broad understanding of managed care and pharmacy benefit management (PBM)… more
- AdventHealth (Maitland, FL)
- …appropriate follow up for account completion. Stays current with payor guidelines, managed care changes to authorization practices, all relevant payor portals ... initial communication with service partners inclusive of medical group, managed care , ancillary and support departments and...according to policy. Is readily available to staff and Lead in person or by phone to answer questions… more
- Molina Healthcare (WI)
- …SKILLS & ABILITIES** : * 7+ years experience in Healthcare Administration, Managed Care , Provider Contracting and/or Provider Services, including 2+ years ... with other operational departments and functional business unit stakeholders to lead or support various Provider Contracting functions. This role primarily leads… more
- Houston Methodist (Katy, TX)
- …competency and professional pathway progression. + Communicates updates/changes to processes, managed care information, throughput, etc., in a timely manner. ... government regulations. + **Audit Oversight & Lifecycle Management** + Lead the management and response process for a variety...after ongoing revenue cycle analysis. Meets with payors and/or Managed Care to discuss aged accounts, adjudications… more
- AdventHealth (Tampa, FL)
- …Customer Service or case management. The Nurse Auditor will work closely with the FH/ Managed Care department anytime there are audits requested by an insurance ... Ocala and Wesley Chapel. **The value you'll bring to the team:** Assist FH/ Managed Care Department when outside agencies conduct audits involving hospital… more
- Robert Half Finance & Accounting (Portland, OR)
- …corporate strategies and foster business growth. * Provide strategic leadership in managed care and healthcare financial operations, ensuring compliance with ... is looking for an experienced Head of Finance to lead financial operations and strategy for our organization in...* At least 5 years of experience in the managed care or healthcare industry. * Proven… more