• Clinical Pharmacy Specialist

    Marshfield Clinic (Marshfield, WI)
    …development experience for hospital-based positions; for individuals working in a managed care setting, no prior experience required. **Preferred/Optional:** ... works with physicians, staff, and committees to optimize the care of patients by providing and supporting drug use...Individuals who have not completed an ASHP accredited residency program will be considered based on the following: Five… more
    Marshfield Clinic (11/26/25)
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  • Quality RN

    CenterWell (Covington, LA)
    …+ Strong knowledge of HEDIS/Stars/CMS + Bachelor's Degree in Nursing + 3+ years of managed care experience + 3+ years of case management experience + Bilingual; ... implementation and management oversight of the company's Medicare/Medicaid Stars Program . The Stars Improvement, Clinical Professional 2 work assignments are… more
    CenterWell (11/19/25)
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  • Quality Improvement RN - Chesapeake

    CenterWell (Hampton, VA)
    …applications **Preferred Qualification** + Bachelor's Degree in Nursing + 3+ years of managed care experience + 3+ years of case management experienceBilingual; ... implementation and management oversight of the company's Medicare/Medicaid Stars Program . The Stars Improvement, Clinical Professional 2 work assignments are… more
    CenterWell (10/16/25)
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  • Provider Contract Data Consultant Sr

    Elevance Health (Tampa, FL)
    …ways to accomplish end results + Works side by side with their program manager **Required Qualifications:** + Requires BA/BS degree in Mathematics, Statistics ... a minimum of 7 years experience in broad-based analytical, managed care payor or provider environment as...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (11/21/25)
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  • RN Clinical Services Lead - Pre Operative Line…

    Hartford HealthCare (Hartford, CT)
    …simulation training centers in the world. When hospitals cannot provide the advanced care , expertise and new treatment options their patients require, they turn to ... with strong interdisciplinary teams, focused on a patient centered care model in a richly diverse work space. Under...Under the direction and general supervision of the Nurse Manager , the registered nurse utilizes evidence based practices in… more
    Hartford HealthCare (11/18/25)
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  • Patient Service Coordinator/CMA (Community…

    Johns Hopkins University (Baltimore, MD)
    …data by phone or in person. + Obtain pre-certifications as required by clients' health care insurers or managed care providers. Arrange or assist in ... (PSC/MA)_** who will work in collaboration with the Sr. Program Coordinator, Center Manager and the Director...in all of our projects, implement and promote clinical care and support in community outreach for infectious disease… more
    Johns Hopkins University (11/04/25)
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  • Patient Services Associate

    Penn Medicine (Schwenksville, PA)
    …pertinent to patient service and billing procedures: including basic knowledge of all managed care plans and which insurers require a copayment or referral. ... our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future...patients regarding patient flow and wait times - keeps manager aware of potential issues as they arise. .… more
    Penn Medicine (10/14/25)
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  • Investigative Officer 1/Investigative Officer…

    New York State Civil Service (Buffalo, NY)
    …related claims processes. Stay abreast of enforcement-related Workers' Compensation Board program requirements.* Proper use of board-issued equipment, such as iPad ... HELPSThis title is part of the New York Hiring for Emergency Limited Placement Statewide Program (NY HELPS). For the duration of the NY HELPS Program , this title… more
    New York State Civil Service (11/26/25)
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  • Contact Lens Coordinator - Ophth Clinical Support…

    Penn Medicine (Philadelphia, PA)
    …or pre-authorization for appointments and products. + Maintains basic knowledge of all managed care plans with which UPHS participates. + Reminds patients to ... 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 (11/05/25)
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  • Senior Claims Specialist

    Festival Foods (WI)
    … offering savings off of fitness membership fees; our EAP (Employee Assistance Program ) and LEAPCare Care Coaches, which provide associates confidential care ... Job Summary Job Title: Senior Claims Specialist Reports to: Workplace Safety Manager The Senior Claims Specialist oversees the administration of first- and… more
    Festival Foods (11/19/25)
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