- Commonwealth Care Alliance (Boston, MA)
- …mission and supporting high-quality, coordinated care for members. In this role, the Program Manager acts as an account manager , relationship manager ... of quality care . The BH Provider Engagement Program Manager reports to the Director of...Desired Experience (nice to have): * Experience working with managed care organizations, value-based programs, or community-based… more
- Health Care Service Corporation (Santa Fe, NM)
- …3 years of equivalent experience in managed care , a state care coordination or waiver program . + Knowledge of healthcare terminology + Experience ... your professional development. **Job Summary** This position is responsible to provide care coordination to members via telephonic and/or field-based care … more
- LA Care Health Plan (Los Angeles, CA)
- …applying: + The candidate selected for this role MUST have recent experience with healthcare/ managed care grievances + The candidate selected for this role must ... care grievance and/or appeals issues, preferably in a managed care or Medicaid Health Plan environment...organizations and business partners. Equivalency: Completion of the LA Care Management Certificate Training Program may substitute… more
- Beth Israel Lahey Health (Wakefield, MA)
- … care management services are provided to the BILHPN provider's risk populations. The Care Manager provides care management services to the BILHPN primary ... to optimize quality, reduce readmissions and decrease total medical expenses. The Care Manager assesses, plans, implements, coordinates, monitors and evaluates… more
- Whitney Young Health Center (Albany, NY)
- …certification. Flexibility to adjust to schedule changes. Knowledge of managed care requirements. Bilingual. RN CARE MANAGER II:Salary range: $76,000 ... Registered Nurse (RN) Care Manager (Req 100984) Albany, NY...certification. Flexibility to adjust to schedule changes. Knowledge of managed care requirements. Bilingual. All qualified applicants… more
- Corewell Health (Grand Rapids, MI)
- …of insurance prior authorizations, initial reviews, continuous stay reviews and appeals. Nurse Care Manager - Plans and prioritizes care for individuals ... the application of educational concepts / skills and preventive care in a managed care ...Life Support (BLS) - ARC American Red Cross Ambulatory Care Management Upon Hire required + Case Manager… more
- Houston Methodist (The Woodlands, TX)
- …by communicating medical information required by all external review entities, managed care contracts, insurers, fiscal intermediaries, state, and federal ... of positive language principles + Comprehensive knowledge of Medicare, Medicaid and Managed Care requirements + Comprehensive knowledge of community resources,… more
- LA Care Health Plan (Los Angeles, CA)
- …Degree Experience Required: At least 6 years of experience in financial auditing in a managed care industry. At least 4 years of leading, supervising and/ or ... verbal and written communication, and presentation skills. Knowledge of relevant managed care regulations and audit methodologies. Excellent analytical and… more
- Corewell Health (Grand Rapids, MI)
- …/ community outcomes through the application of educational concepts / skills and preventive care in a managed care environment. + Assesses internal and ... years of relevant experience clinical nursing and or case management/ managed care or related field Required +...- State of Michigan Upon Hire required + Case Manager , Certified (CCM) - CCMC Commission for Case … more
- AmeriHealth Caritas (Washington, DC)
- …point of contact and be an advocate for members in the care management program . In addition, the Care Manager (RN/LICSW) will participate in meetings in ... **Role Overview** The Care Manager (RN/LICSW) assists members appropriate...experience supporting Medicaid members and/or pediatric populations within a managed care organization preferred **Licensure** + Current… more