- Trinity Health (Ann Arbor, MI)
- …of all phases of patient care , guided by progress notes, consults, care plans, critical pathways, managed care guidelines, best practice protocols, ... **Description:** **Position Purpose** The Overnight Surgical Specialty NP/PA provides health care services under the direction of collaborating ENT surgeons, Urology… more
- Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
- …Omnibus Budget Reconciliation Act (COBRA) and abuse/neglect reporting. + Communicates with managed care organizations to obtain insurance pre-authorizations in a ... Santa Rosa and Northern California mental health system of care . Conveniently located in the North Bay, this hospital...working collaboratively as well as possessing the skills to lead , influence, and motivate others + Ability to work… more
- Molina Healthcare (GA)
- …At least 5 years of health care experience, and at least 2 years of managed care experience in one or more of the following areas: utilization management, ... healthcare services professionals in some or all the following functions: care management, utilization management, behavioral health, care transitions, long-term… more
- Trinity Health (Pontiac, MI)
- …established protocols. Assures appropriate advice is given to patients and families. Assures managed care guidelines are adhered to in terms of patient access. ... Objectives:** Assumes a leadership role in providing professional nursing care to patients within Mercy Cancer Care ...and perceiving our world and that these differences often lead to innovative solutions. Our dedication to diversity includes… more
- Dignity Health (Santa Maria, CA)
- …company policy. CRE II Basic knowledge of the healthcare industry, Medicare, managed care , insurance reimbursement and accounting practices. Knowledge of ... coach, responsible for the supervision of assigned CRE(s) and/or Care Transition Nurse(s). The CRE II is also the...contracting. Demonstrated ability to effectively lead , train, develop, evaluate and manage staff performance. Possesses… more
- WellSpan Health (Mount Gretna, PA)
- …using computerized inquiry functions. + Maintains a knowledge base of insurance/ managed care processes related to pre-certifications and authorizations and ... safety observation recommendations in the ED. + Determines appropriate level of care based on the client's history, psychosocial history, clinical presentation, and… more
- Evolent (Salem, OR)
- …experience in claims-based healthcare analytics with a payer, provider, clinical vendor, managed care , or related healthcare consulting entity + Ability to ... people with most complex and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented health care … more
- Elevance Health (Macon, GA)
- …required. **Preferred Capabilities, Skills and Experiences:** + Nursing experience in Home Health, Managed Care , Case Management, or Care Coordination. + ... Case Manager Senior - Field Nurse** 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
- UnityPoint Health (Waterloo, IA)
- …in the state of Iowa Experience: + 5 years' experience in healthcare or managed care setting + Demonstrated results in leading interdisciplinary teams, care ... Responsible for the development, implementation and evaluation of the care provided for Care Management which is...of concerns that have the potential to escalate or lead to Risk Management concerns. + Evaluates and guides… more
- CVS Health (TX)
- …experience with a Health plan/payor experience. *Electronic medical systems/record experience * Managed Care experience *Board certification in Internal Medicine, ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more