- University of Michigan (Ann Arbor, MI)
- …systems. + Partner with the Manager of Managed Care Operations and the Senior Director of Managed Care Contracting and Operations to plan, coordinate, ... skills and experience that directly relate to this position. **Job Summary** The Managed Care Contracting and Operations (MCCO) Department is responsible for the… more
- Houston Methodist (Sugar Land, TX)
- At Houston Methodist, the Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the clinical ... as appropriate, DRG recoupments/downgrades, and denials for no authorization. The Senior Denials Management Specialist position communicates clinical information… more
- CareFirst (Baltimore, MD)
- …submissions. Utilizes coding expertise, combined with medical policy, credentialing, and contracting rules knowledge to build the effective guides and resources for ... and integration of medical codes across policies and platforms. The Senior Coding Analyst partners with medical policy analysts, configuration teams, and… more
- Entergy (New Orleans, LA)
- **Job Title:** Senior Category Management Specialist **Work Place Flexibility:** Hybrid **Legal Entity:** Entergy Services, LLC **Please note:** Authorization to ... a Supply Chain - Strategic Procurement Corp Professional (Category Management Specialist ) responsible for enabling Supplier Commercial Excellence for the Corporate… more
- Molina Healthcare (Rockford, IL)
- Molina Healthcare is hiring a Sr Specialist in our Government Contracts department. This role is remote with a high preference for candidates who reside in Illinois. ... The Sr Specialist in our Government Contracts will be responsible for...experience-** + Live in Illinois and are familiar with Managed Care in Illinois and how HHF operates. +… more
- Molina Healthcare (GA)
- …(eg, Provider Services/Provider Inquiry Research & Resolution, Provider Contracting /Provider Relationship Management). + Provides timely, accurate generation and ... equivalent combination of education and experience **Required Experience** + 3-5 years managed care experience, including 2+ years in Provider Claims and/or Provider… more
- Molina Healthcare (Milwaukee, WI)
- …requirements prior to submission. + Assesses information received from government contracting agencies and regulators and disseminates to impacted Plan staff. + ... or equivalent **Required Experience** + 3 years' experience in a managed care environment. + Experience demonstrating strong: communication and presentation skills;… more
- Pacific Medical Centers (Renton, WA)
- …network and utilization issues. Responsible for a key role in provider contracting and network relations. Providence caregivers are not simply valued - they're ... best people, we must empower them. **Required Qualifications:** + 5 years Managed care operations. + Extensive experience and understanding of capitated medicine,… more
- Centene Corporation (Jefferson City, MO)
- …remote. Candidates will be considered nationally. **Responsibilities:** + Acts as senior level contract specialist , providing peer mentorship and training ... on workplace flexibility. **Position Purpose:** Subject matter expert and senior member of the Procurement Contract team with tasks...strategies. + Acts as second level reviewer of contracts managed by junior level peers. + Maintains detailed and… more
- State of Minnesota (Shakopee, MN)
- …remediating contaminated properties. (Advanced professional-level experience is equivalent to Senior Environmental Specialist , Environmental Specialist 3 ... **Working Title: Remediation Project Coordinator - Environmental Specialist 4** **Job Class: Environmental Specialist 4** **Agency: Pollution Control Agency** +… more