- Excellus BlueCross BlueShield (Rochester, NY)
- …Must demonstrate proficiency with the Microsoft Office Suite. + Experience in interpreting managed care benefit plans and strong knowledge of government ... we encourage you to apply! Job Description: Summary: Conducts case management program activities in accordance with departmental, corporate, NYS Department of Health… more
- Humana (Oshkosh, WI)
- …to building vibrant and inclusive communities, Inclusa deploys a unique approach to managed care with a trademarked model of support named Commonunity(R) which ... the Inclusa/Humana team, serving members in the Wisconsin Family Care (FC) program . In this dynamic role,...to thrive in their daily lives. As a Case Manager , you will provide comprehensive social service care… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …staff. The ideal candidate will have a strong clinical background within a managed care setting including a high-level understanding of prior authorization ... About The Role The Manager , Utilization Management (UM) will manage the Utilization...+ Bachelor's degree in nursing, (or equivalent experience within managed care environment) + 5 or more… more
- HCA Healthcare (Las Vegas, NV)
- …of the range. **Introduction** Are you ready to manage in a new era as a Manager of Emergency Services- where building a healthier tomorrow is more than a job? Our ... auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. + Free counseling… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …policies and procedures to comply with medial staff bylaws, hospital bylaws, managed care policies, TJC/NCQA requirements and related state and federal ... medical staff office operations. + Maintain a file audit program ensuring audit and survey preparedness. + Coordinates transmittal...(5) years comprehensive Medical Staff Services in an acute care hospital, managed care or… more
- University of Washington (Seattle, WA)
- …and performs front-desk duties for the clinic. The Graduate Prosthodontics Clinic Manager regularly collaborates with the Graduate Program Director, Department ... School of Dentistry has an outstanding opportunity for a Graduate Prosthodontics Clinic Manager (Patient Services Specialist Supv (NE S SEIU 925 Supv)) to join their… more
- Boulder Community Hospital (Boulder, CO)
- Case Manager - LPC / LCSW - Behavioral Health Boulder... network. The position requires an ongoing knowledge of managed care and how best to deal with ... weekend shifts. Boulder Community Health is seeking a Case Manager LPC or LCSW that is responsible for providing...or LCSW that is responsible for providing psychotherapy and care management services. The position requires the ability to… more
- Elevance Health (Sacramento, CA)
- …+ Travels to the worksite and other locations as necessary preferred. + Managed care experience preferred. For candidates working in person or virtually ... for autism and depression, and insightful analytics to improve the delivery of care . The **Provider Quality Manager ** is responsible for leading Behavioral… more
- CVS Health (St. Paul, MN)
- …Qualifications** + 8+ years of professional work experience within the PBM or Managed Care arenas. + Experience establishing relationships with key internal ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- Molina Healthcare (New York, NY)
- …improving provider Quality performance through provider engagement, practice transformation, managed care quality improvement, or equivalent experience. * ... **Job Description** **Job Summary** The Provider Engagement Manager implements Health Plan provider engagement strategy to achieve positive quality and risk… more