- CareFirst (Baltimore, MD)
- …+ Previous experience as medical director for a health care company and/or payer organization. + Working knowledge of both commercial and government programs lines ... of business. **Knowledge, Skills and Abilities (KSAs)** + Proficient in utilization management processes, quality assurance standards, and managed care. + Strong people management and leadership experience in a clinical environment. + Writes and presents… more
- Dignity Health (San Andreas, CA)
- …of the point of sale machine. Verifying identity and signatures of the payer prior to purchasing services. The Health and Education Coordinator will manage all ... employee health activities to assure optimum health for our employees. These activities include, but are not limited to the following: manages new hire process, annual requirements, vaccinations, EH record maintenance, and management of injured workers through… more
- BrightSpring Health Services (Irving, TX)
- …industry trends/competitive activity and updates information as needed. + Completes payer pipeline and account information projects as required. + Collaborates with ... operational and clinical team members to ensure the very best outcomes for all patients. + Participates in weekly sales team calls and bi-weekly coaching calls as directed by Director of Business Development. + Participates in special projects and performs… more
- Robert Half Office Team (Princeton, NJ)
- …and maintaining practitioner documentation in accordance with regulatory, payer , and organizational requirements. Key Responsibilities: + Collect credentialing ... and re-credentialing applications, licenses, certifications, and supporting documentation from healthcare providers. + Complete primary source verification for provider qualifications, including education, licensure, board certification, and employment… more
- R1 RCM (Mesquite, NV)
- …of the top 100 US health systems, and handles over 270 million payer transactions annually. This scale provides unmatched operational insight to help healthcare ... organizations unlock greater long-term value. To learn more, visit: https://www.r1rcm.com . more
- HCA Healthcare (Walterboro, SC)
- …an educational resource to patients, families, interdisciplinary team members, payer representatives, and other parties as appropriate regarding behavioral ... services.** + **** **Reviews, coaches, and assists with training of new staff/interns as assigned within approved practice and program guidelines.** + **** **Participates in developing department goals/objectives and clinical programming.** + ****… more
- Riverside Community Care (Dedham, MA)
- …excellence by aligning programs and practices with federal, state, and payer requirements while advancing safe, ethical, and person-centered care across the ... continuum of services. As Vice President of Quality Management, you will: + Serve as Riverside's Compliance and Privacy Officer, guiding our organization in HIPAA/privacy, human rights, accessibility, policy governance, and records management + Oversee our… more
- Ochsner Health (Lafayette, LA)
- …admission, and continued stay reviews as directed per CMS guidelines, commercial payer guidelines, and/or hospital policy. + Supports the values of service ... excellence, teamwork and integrity and maintains minimum standards for licensure and strives for personal/professional development. + Maintains knowledge of the conditions of participation as it relates to utilization review and discharge planning. + Maintains… more
- R1 RCM (Pensacola, FL)
- …of the top 100 US health systems, and handles over 270 million payer transactions annually. This scale provides unmatched operational insight to help healthcare ... organizations unlock greater long-term value. To learn more, visit: https://www.r1rcm.com . more
- BrightSpring Health Services (San Antonio, TX)
- …Associate's Degree or some college preferred + Experience working with all payer types, including Medicare, Medicaid and commercial insurance companies + Knowledge ... of insurance verification and pre-certification procedures + Understands the scope of services that Amerita can provide + Strong verbal and written communication skills **To perform this role will require constantly sitting, standing and typing on a keyboard… more
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