- UPMC (Pittsburgh, PA)
- …of the National Committee on Quality Assurance (NCQA) Standards for the accreditation of managed care organizations HEDIS specifications; the managed care ... supports various functions within the scope of the Health Plan Quality Improvement Program, working both independently and as...of improvement initiatives. - Bachelor's degree in a health care field or equivalent work experience required. - BSN… more
- SSM Health (Richmond Heights, MO)
- …and pre-authorizes according to insurance plan requirements. + Logs, tracks and reviews managed care approvals and denials. + Responds in a timely manner to ... **Job Summary:** Coordinates provider referrals, pre-certifications, and pre-authorizations for managed care insurance plans. **Job Responsibilities and… more
- Henry Ford Health System (Detroit, MI)
- …various internal HFH areas. + Develops and maintains an adequate understanding of managed care , CMS and UNOS guidelines relative to transplantation and financial ... detail oriented person interested in joining a team dedicated to comprehensive care that offers patients a second chance at life? This non-exempt position… more
- Henry Ford Health System (Clinton Township, MI)
- …or bachelor's degree is preferred. + Five (5) years in a hospital and/or managed care credentialing setting is required. + Medical staff services experience ... full continuum of services - from primary and preventative care to complex and specialty care , health...and spiritual. Our Total Rewards program includes competitive health plan options, with three consumer-driven health plans (CDHPs), a… more
- UPMC (Camp Hill, PA)
- …to join the Community HealthChoices team! Community HealthChoices (CHC) is Pennsylvania's managed care long-term services and supports (LTSS) program serving ... UPMC Health Plan is looking for Service Coordinators in the...To provide service coordination services across the continuum of care through a community-based approach to improve the health… more
- Northern Light Health (Bangor, ME)
- …will, when and how they say they will, or communicates an alternate plan . + Cultivates Respect: Treats others fairly, embraces and values differences, and ... work impacts everyone involved. + Practices Compassion: Exhibits genuine care for people and is available and ready to...Hospital is a broad behavioral health delivery system centrally managed from its location in Bangor, Maine. Acadia Hospital… more
- Expeditors (Bensenville, IL)
- Company Description We take care of our employees, and they take care of our customers! Become a member of a global community! The international logistics ... delivering per KPI's, RDL's and SOP's + Exceptions are managed and resolved immediately. + Communicate effectively and timely...Information + Paid Vacation, Holiday, Sick Time + Health Plan : Medical, Prescription Drug, Dental and Vision + Life… more
- Molina Healthcare (Albany, NY)
- …functionality, as well as Microsoft. + Role specific industry experience in Long-Term (LT) or Managed Long-Term Plan (MLTCP). + Experienced in one or more of the ... toward identification of qualified, eligible prospects related to both long-term care needs and Medicaid coverage for enrollment. Assist our current members… more
- Centene Corporation (Honolulu, HI)
- …degree in Social Work or equivalent experience. 2+ years of experience in managed care and/or behavioral healthcare setting. Experience with patients with ... fresh perspective on workplace flexibility. **Position Purpose:** Work with Foster Care members, Medical Consenters, Department of Family and Protective Services… more
- Centene Corporation (Honolulu, HI)
- …degree in Social Work or equivalent experience. 2+ years of experience in managed care and/or behavioral healthcare setting. Experience with patients with ... fresh perspective on workplace flexibility. **Position Purpose:** Work with Foster Care members, Medical Consenters, Department of Family and Protective Services… more