- Elevance Health (Washington, DC)
- **Medical Management Specialist I** **Location:** Washington, DC. This role requires associates to be in-office 4 days per week, fostering collaboration and ... by law. **Schedule:** Monday-Friday 8:00AM-5:00PM or 8:30AM-5:30PM EST The **Medical Management Specialist I** will be responsible for providing non-clinical support… more
- CVS Health (Columbus, OH)
- …Solutions (MPPS) team. This individual contributor will provide clinical project management support, policy and project monitoring for Medical Policy and Program ... and policies. They will collaborate with Payment Integrity for end-to-end management , including: + Conduct quality assessment and implementation of legislative… more
- Centene Corporation (Austin, TX)
- …of contract and rate negotiations, developing complex benefits that support Medicaid -Medicare, and maintaining a competitive, innovative portfolio. + Lead large ... working with organizational leaders. Oversee all aspects of program planning, management , and execution (scope, schedule, and budget). Create comprehensive timelines… more
- Centene Corporation (Indianapolis, IN)
- …preferably in a large primary care office or clinic setting working with Medicaid or the uninsured. Experience in conflict management or data reporting ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more
- Geisinger (Pittston, PA)
- …with patients, obtains information and completes required tasks to determine patient's eligibility for Medicaid and other federal, state, and local government ... and out surgeries and outpatient clinical departments. + Follows Revenue Management policies and procedures regarding financial matters and payment arrangements. +… more
- Centene Corporation (Sacramento, CA)
- …and appropriate level of care preferred. Expert knowledge of Medicare and Medicaid regulations preferred. Expert knowledge of utilization management processes ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more
- Rochester Regional Health (Rochester, NY)
- …Participates and supports oversight of office processes of the Medical Management Department to maintain daily operations. Oversees the daily review process ... of third party payors are maintained. Creates departmental reports for senior management . RESPONSIBILITIES + Oversees the review process of third party payors with… more
- CVS Health (Lansing, MI)
- …business issues and initiatives through direction setting and project management work. Responsibilities include assimilating information to proactively develop ... activities aligned with program goals and objectives; linking the quality management activities to business goals; advance business objectives by supporting and… more
- Atlantic Health System (Newton, NJ)
- …by using the techniques of system design, reengineering, project management , patient safety, quality improvement, outcomes measurement, and statistical analysis ... standardized benchmarks and definitions and corporate requirements. This includes: project management , training, data management , and activities to support… more
- Point32Health (Canton, MA)
- …. **Job Summary** The Director, Ancillary Contracting leads the development and management of Point32Health's ancillary service network. The Director manages a team ... of managers, whose contract management teams are responsible for reimbursement strategies, negotiating and...for approximately 30 different ancillary service lines for Medicare, Medicaid and Commercial product lines. The Director also identifies… more