- RiseBoro Homecare Inc. (Brooklyn, NY)
- …Intake and Coordination team. . Advocate for client needs with respective HRA, CASA, MCO , and MLTC offices and other service providers. . Consult and follow up with ... billing in coordination with responsible Homecare units and designated HRA, CASA, MCO , and MLTC offices. . Maintain accurate records of authorization, status change,… more
- Comunilife (Bronx, NY)
- …Health (NYS DOH), Health Home Lead agencies, and Managed Care Organization ( MCO ) requirements. The APD oversees the full continuum of program operations, including ... corrective actions as needed. + Lead responses to Health Home Lead audits, MCO reviews, and state monitoring visits. + Develop and update internal policies and… more
- Elevance Health (TN)
- …Medicaid programs, dual eligible members and other membership as assigned by our MCO partners. + Develops and implements clinical plans of care for adult patients ... facing chronic and complex conditions (eg, co-morbid medical and mental health diagnoses, limited personal resources, chronic medical conditions.). + Gathers history and physical exam and diagnostics as needed and then develops and implements treatment plans… more
- Boehringer Ingelheim (Fresno, CA)
- …Payor formularies. + Works in concert with an extended team to pull-through MCO decisions. + Analyzes territory information to optimize Health System and key ... stakeholder interactions. + Is knowledgeable of barriers and opportunities that impact business and promptly informs account team of any developments. + Is aware of opportunities that meet both Health System needs as well as account plans and brand tactics. +… more
- City of New York (New York, NY)
- …guidelines established by NYCDOHMH, NYSDOH, Article 28/NYS, CDC, HRSA/340b, and relevant MCO guidelines. - Communicating new and updated protocols and procedures to ... Sexual Health Clinic clinicians through trainings, written memos. - Facilitate environment for professional development of clinicians through development and sharing of scientific research, publications, continuous training. - Working collaboratively with… more
- Sanford Health (Sioux Falls, SD)
- …16.1 in a Citrix environment with all new FAS/GPU's, RapidArc, RapidPlan and MCO . Portal Dosimetry is used for routine IMRT QA. RadCalc, Velocity, and Radformation ... products (AutoContour, Clearcheck and EZFluence) are used. A GE Optima CT scanner is used for simulations. A Varian GammaMed Plus iX HDR unit is used to support the GYN brachytherapy practice. QA equipment is primarily Sun Nuclear with SunCHECK software.… more
- USAA (Tampa, FL)
- …+ P&C Property Claims Operations and/or Optimization experience + 2+ years MCO experience + Deep operational knowledge of end-to-end Property Claims processes + ... Demonstrated knowledge or experience with vendor management + Demonstrated knowledge of new and emerging industry technology solutions + Proven ability to use analytical tools and data to inform business decisions + Proven thought leader + US military… more
- Elevance Health (Baton Rouge, LA)
- …Hepatitis, HIV, and Hypertension preferred + Experience in hospital, case management, MCO experience preferred. + Combination of the following is a plus: Acute ... care, home health, chronic illnesses/diseases, discharge planning. + Behavioral health conditions experience preferred Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health.… more
- CVS Health (Lansing, MI)
- …**Preferred Qualifications** + 1+ year of experience in a managed care organization ( MCO ). + Experience in a high-volume clinical call center or prior remote work ... environment. **Education** + Associate's degree in nursing (RN) required, BSN preferred. **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $29.10 - $62.32 This pay range represents the base hourly… more
- Molina Healthcare (Richardson, TX)
- …previous experience working with the Medicaid population within a Managed Care Organization ( MCO ). Mileage is reimbursed as part of our benefits package. Hours are ... Monday - Friday, 8 AM - 5 PM CST. Solid experience with Microsoft Office Suite is necessary, especially with Outlook, Excel, and Teams as well as being confident in moving between different programs to complete the necessary forms and documentation. Job… more