- CVS Health (Trenton, NJ)
- …of the MLTSS Program and adherence to contractual requirements. The Associate Manager will oversee Care Managers (CM)s who are assigned to members in ... engage directly with state partners to ensure alignment with program goals and regulatory expectations. The Associate Manager...years of previous leadership experience in a healthcare or managed care environment. + Demonstrated ability to… more
- LA Care Health Plan (Los Angeles, CA)
- …and interdisciplinary care professionals in a hospital, medical group or managed care setting, such as a health insurance environment and/or experience ... incentives or any additional service needs according to specific program guidelines. Uses claims processing and care ...as care manager in home health or hospice...as care manager in home health or… more
- Houston Methodist (The Woodlands, TX)
- …services by communicating medical information required by all external review entities, managed care contracts, insurers, fiscal intermediaries, and state and ... admission, continued stay and resource use, appropriate level of care and program compliance. Identifies when services...and role components + Knowledge of Medicare, Medicaid and Managed Care requirements + Comprehensive knowledge of… more
- Molina Healthcare (Columbus, GA)
- …: * 5-7 years of Program and/or Project management experience. * Managed Care experience. * Experience working in a cross functional highly matrixed ... DESCRIPTION** **Job Summary** This position is the product owner for the Care Mangement system. Responsible for internal business projects and programs involving… more
- Access Dubuque (Dubuque, IA)
- …+ At least 2 years' experience in a client facing or consultative role within the managed care or PBM setting + Must be a strong communicator with the ability ... of the PBM industry, formulary management, pharmacy claims and managed care principles and practices + Residency...Featured Job TH Ad TH Comments **Similar Jobs** Marketing Program Manager Flexsteel Industries, Inc Assistant Store… more
- US Physical Therapy (Houston, TX)
- …a **Contract Manager /Analyst.** This is a dual role that will support the ** Managed Care Operations Team** . The person in this role should have experience ... in Managed Care , WC, Replacements & Auto lines...in Managed Care , WC, Replacements & Auto lines of business. They...and leadership + Employee discount plans + Employee Assistance Program (EAP) + Investment from a company that wants… more
- Western Digital (Richmond, VA)
- …* **8+ years** in legal business consulting, legal technology innovation, or legal managed services * Strong technical program management with large-scale legal ... Legal at Western Digital. **ESSENTIAL DUTIES AND RESPONSIBILITIES:** **Technical Program Management Excellence** * Lead cross-functional programs spanning Legal, IT,… more
- Penn Medicine (Plainsboro, NJ)
- …practice revenue cycle management/oversight. Ensure practice alignment with all standards. Managed Care /Payer Management - Support implementation of managed ... is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field… more
- Penn Medicine (Philadelphia, PA)
- …coding, cash management, charge entry, etc. Ensure practice alignment with all standards. Managed Care /Payer Management - Support implementation of managed ... is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field… more
- Molina Healthcare (Grand Island, NE)
- …5 years in healthcare, with 2+ years in health plan quality improvement or managed care . (HIGHLY PREFERRED)** + **Strong knowledge of NCQA standards and EQRO ... work of external vendors. Assigns, directs and monitors system analysis and program staff. These positions' primary focus is project/ program management. **Job… more