- Stony Brook University (Stony Brook, NY)
- …Provide project management and construction management to trades personnel and contract labor personnel performing work on new construction and renovation ... of work covers assigned areas of SBUH / HSC, as well as managed satellite facilities. + Responsible for notifying appropriate department heads and/or their designers… more
- Elevance Health (KS)
- ** Managed Care Coordinator ** Location:...of position, as required by applicable state law and contract . **How you will make an impact:** + Responsible ... responsiveness to client needs, and direct, hands-on engagement. The ** Managed Care Coordinator ** is responsible...experience may be required based upon state law and contract requirements. + Community Health Worker certification to be… more
- InGenesis (Columbia, SC)
- InGenesis is currently seeking a Registered Nurse / RN - Managed Care Coordinator to work for our client located in Columbia, SC. In this role you will ... of clinical information to support and determine medical necessity criteria and contract benefits. * Utilize allocated resources to back up review determinations. *… more
- US Tech Solutions (Columbia, SC)
- …and to coordinate with team, providers, and patient representatives regarding patient care . + Skill sets/qualities: Same as required skills listed in job ... of clinical information to support and determine medical necessity criteria and contract benefits. + Provides telephonic support for members with chronic conditions,… more
- Centene Corporation (Nashville, TN)
- …1+ years of provider data or network administration experience, preferably in managed care . Proficient in Microsoft Office applications, preferably Access and ... with State requirements. + Create and maintain appropriate databases, including: contract network, authorization, third party liability, provider set up corrections,… more
- Immigration and Customs Enforcement (Port Isabel, TX)
- …Managers, BH Medical Assets Support Team), and other IHSC personnel (ie, Field Medical Coordinator , Managed Care Coordinator , etc.), other health ... civil servants, and contract staff. The IHSC provides on-site direct patient care to ICE detainees at 20 detention facilities throughout the country and manages… more
- AdventHealth (Maitland, FL)
- …adjudication. Provides guidance and direction to PFS, Central Denials, Patient Access and Managed Care staff regarding contract terms and policies including; ... performance and allows AdventHealth the ability to accurately model contracts for future negotiations. The accuracy of these builds...contract data elements which are populated into the Managed Care database including addition of new… more
- Humana (Northfield, IL)
- …with resources appropriate for the care and wellbeing of members. The LTSS Care Coordinator ( Care Coach 1) employs a variety of strategies, approaches, ... techniques to manage a member's health issues. The LTSS Care Coordinator ( Care Coach 1)...care services, Home and Community-Based Services (HCBS), and/or managed care organizations. + Intermediate to advanced… more
- Educational Alliance, Inc. (New York, NY)
- …delivery and adherence to program standards. + Monitor compliance with Medicaid waiver requirements, managed care contracts , and Social Care Network ... readiness for external audits or site visits by regulatory agencies or managed care organizations. + Maintain up-to-date knowledge of Medicaid regulations,… more
- Banner Health (Phoenix, AZ)
- …Educates other health care providers, payors and patients on concepts of managed care , managed care networks, transplant networks, individual ... **Department Name:** Pre-Kidney Trans-Hosp **Work Shift:** Day **Job Category:** Clinical Care Great options and great opportunities. Banner Health has both the… more
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