- Cedars-Sinai (CA)
- **Job Description** The Managed Care Compliance Specialist is responsible for assisting with the implementation of the internal auditing and monitoring ... contract language for Commercial, Medicare and Medi-Cal managed care . + Acts as a liaison...and beyond. **Req ID** : 11981 **Working Title** : Managed Care Compliance Specialist -… more
- JPMorgan Chase (Columbus, OH)
- …center of high-impact collaboration with senior leaders and industry experts. As the Contract Specialist within JP Morgan's Asset Management you are an ... Take charge of the contract management process for JP Morgan's diverse investment...Mutual Funds, Global Liquidity, 529, Commingled, ETF, Alternatives and Managed Account businesses. This includes responsibility for the approval… more
- Aegis Therapies (Fort Smith, AR)
- …and assignments related to the review, analysis, negotiation, modification, and execution of managed care contracts for the company and its affiliates. + ... Position: Contract Specialist + Hours: PRN + Setting: Corporate + Location: Fort Smith, AR At Aegis Therapies, you'll be part of a team that truly makes a… more
- Pacific Medical Centers (Renton, WA)
- …the best people, we must empower them. **Required Qualifications:** + 5 years Managed care operations. + Extensive experience and understanding of capitated ... there is compliance with all elements of the TRICARE Management Activity contract . Understands the attitudes and values of the community and establishes effective… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …collections of outstanding account balances for commercial, government, and managed care payors as assigned. The Reimbursement Specialist I is required to ... their leadership. It is a requirement for the Reimbursement Specialist I to read, interpret and apply complex payor... I to read, interpret and apply complex payor contract language to expected reimbursement calculations and pursue all… more
- Guidehouse (San Antonio, TX)
- **Job Family** **:** Financial Account Specialist **Travel Required** **:** None **Clearance Required** **:** Ability to Obtain Public Trust **What You Will Do** ... components. * Provides oversight and executive level management to overcall contract operations often involving multiple projects/tasks and groups of personnel at… more
- Molina Healthcare (Dallas, TX)
- …effective and efficient business results. * Trains and monitors newly hired Contract Specialist (s). * Participates in other contracting related special projects ... does not entail heavy negotiations. Minimal ongoing engagement after contract . Synchronizes data among multiple claims systems when applicable,... field including, but not limited to, provider's office, managed care , or other health care… more
- Area Agency On Aging 1-b (Southfield, MI)
- …years of experience in an administrative clinical setting, including 1-2 years Medicaid managed care appeals process & Health/Human Services. + Proven ability to ... The Appeals and Grievance Specialist is responsible for managing and resolving appeals...thinking, and problem-solving skills. + Possesses experience in Medicaid managed care appeals process, HIPAA privacy rules,… more
- University of Washington (Seattle, WA)
- **Job Description** **Position Purpose:** The Grants Manager (Program Operation Specialist (ES 7) will serve as a key member of the Institute for Protein Design ... any one time, bringing in over $50M grant and contract revenue, and it requires at least two experienced...IPD currently has $50M in direct costs for FY24, managed by a team of research and fiscal managers.… more
- New York State Civil Service (New York, NY)
- …billing patterns and troubleshooting reimbursement practices that are inconsistent with model managed care contract . * Supervise staff, including time ... limited to the following:* Provide direct management and oversight of the Medicaid Managed Care Behavioral Health plan audits, including desk reviews, written… more
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