- Pfizer (Olympia, WA)
- …as appropriate. The individual may be involved in presentations to payers, managed care organizations, formulary decision makers and regional medical advisory ... of the following: + Clinical, formulary, and/or other management experience + Managed Care , pharmaceutical industry, and/or Quality Improvement + Data Analytics… more
- Henry Ford Health System (Troy, MI)
- …contracting, provider relations or provider reimbursement experience. + Knowledge of managed care organizations and integrated health systems. + Comprehensive ... of Contract Strategy and work directly with Payors to lead negotiation of contractual provisions and rates on behalf...Excel. Additional Information + Organization: Corporate Services + Department: Managed Care Contracting + Shift: Day Job… more
- Houston Methodist (Houston, TX)
- …application of positive language principles + Knowledge of Medicare, Medicaid and Managed Care requirements + Progressive knowledge of community resources, ... of discharge planning, utilization management, case management, performance improvement and managed care reimbursement + Understanding of pre-acute and… more
- Elevance Health (Latham, NY)
- …acute care setting. + Minimum 2 years "telephonic" Case Management experience with a Managed Care Company. + Managed Care experience. For candidates ... The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
- CenterWell (Orlando, FL)
- …+ Basic knowledge of Population Health Strategy + Bachelor's Degree + Medicare knowledge + Managed care experience + Value Based Care knowledge + Proven ... experience + Direct leadership experience and demonstrated ability to lead , coach and mentor teams + Proven interpersonal skills...of an interdisciplinary team + Solid understanding of medical care delivery, managed care financial… more
- Centene Corporation (Bronx, NY)
- …including "metal" products offered through the New York State of Health (NYSOH), Medicaid Managed Care , Child Health Plus, Medicare, MLTC, FIDA and HARP. Ability ... the Sales Force CRM as an activity tracking and lead /referral tracking tool, to manage appointments and follow up,...GED, required. 2 to 5 years prior experience in managed care , sales, customer service or related… more
- Molina Healthcare (Idaho City, ID)
- …guidelines. + Experience in Utilization/Quality Program management + HMO/ Managed care experience **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** ... and action plan, which includes strategies that ensure a high quality of patient care , ensuring that patients receive the most appropriate care at the most… more
- CenterWell (Decatur, GA)
- …in a Cardiology setting + Bachelor's Degree + Bilingual in both English and Spanish + Managed care experience + Value Based Care knowledge + Proven ability ... TB. + Direct leadership experience and demonstrated ability to lead , coach and mentor teams + Proven interpersonal skills...of an interdisciplinary team + Solid understanding of medical care delivery, managed care financial… more
- Elevance Health (Mason, OH)
- …the applicable medical policy and industry standards, accurately interpreting benefits and managed care products, and steering members to appropriate providers, ... to interpret and apply member contracts, member benefits, and managed care products strongly preferred for associates...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
- MyFlorida (Tallahassee, FL)
- …waivers and home and community based waivers), administrative rules, coverage policies, managed care plan contracts, bill analyses, drug utilization review ... regulations, and guidelines. The incumbent will serve as the lead point of contact for their assigned Medicaid contracts...for carrying out research and policy development related to Managed Care Policy and Contract Development. Specific… more