- CareFirst (Baltimore, MD)
- …plan or health insurance operations (eg networks, eligibility, benefits). + Knowledge of managed care principles and concepts including Health Plan Employer Data ... DC or Northern Virginia metropolitan area.** **PURPOSE:** The Inpatient Management Care Management Supervisor will direct and coordinate the activities of both… more
- AIG (Charlotte, NC)
- …reviews with project stakeholders and IT leaders. + Manage workload and Project Manager staffing levels across the Hybrid Cloud project portfolio. + Maintain ... every community we serve. How you will create impact The Infrastructure PMO Lead - Hybrid Cloud is responsible for global IT project delivery for Hybrid Cloud… more
- Sharp HealthCare (San Diego, CA)
- …clinical practice of medicine. + Previous experience as a physician executive in a managed care environment, preferably as an HMO Medical Director. + California ... a system that gives feedback to providers individually and collectively regarding managed care effectiveness of individual providers and networks. + Assists… more
- 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 ... to support operations team as needed This is a flex- hybrid role which will require you to be onsite...years' experience with CMS processes in a Medicare or Managed Care environment required + Experience with… more
- Omaha Children's Hospital (Omaha, NE)
- …requirements and standard practice. + Ability to review, interpret and understand managed care contracts with third-party payors. + Knowledge of the ... **Schedule: FT, Mon - Fri, 8-5 Hybrid ** At Children's, the region's only full-service pediatric...current healthcare climate, including managed care developments, HIPAA standards and governmental… more
- CareFirst (Baltimore, MD)
- …Management or Case Management at CareFirst BlueCross BlueShield, or similar Managed Care organization or hospital. Demonstrated leadership skills. **Preferred ... who is willing and able to work in a hybrid model. The incumbent will be expected to work...training presentations for internal and external stakeholders. Supports the Manager of Clinical Appeals and Analysis in the development… more
- Sharp HealthCare (San Diego, CA)
- …a system that gives feedback to providers individually and collectively regarding managed care effectiveness of individual providers and networks. + Assists ... plans to address issues and improve plan and network managed care performance. + Collaborates with Chief...of all clinical appeals and grievances. Collaborates with Customer Care Manager to identify trends in grievances.… more
- Integrative Emergency Services (Dallas, TX)
- …Groups/Rosters with the various government and insurance healthcare payors, network managed care contracting plans, and third-party billing entities. This ... and physicians in pursuit of the highest quality health care . Role will be a hybrid schedule,...+ Conveys issues and status of problems to Enrollment Manager . + Ensures Held A/R enrollments are submitted on… more
- The Cigna Group (Bloomfield, CT)
- …with current active US Pharmacist License + 2+ years of pharmacy/ PBM/ Managed Care /healthcare related experience + 1+ years of formulary management/development ... **This is a Hybrid position (3 days per week in-office +...wholesalers. Express Scripts by Evernorth, a leading pharmacy benefit manager with the nation's largest mail order-pharmacy operations, assists… more
- Henry Ford Health System (Troy, MI)
- …contracting, provider relations or provider reimbursement experience. + Knowledge of managed care organizations and integrated health systems. + Comprehensive ... Reporting to Director or Manager , assist in the development of Contract Strategy...Excel. Additional Information + Organization: Corporate Services + Department: Managed Care Contracting + Shift: Day Job… more
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