- AdventHealth (Maitland, FL)
- …government and non-contracted products. Provides expert guidance to Regional Directors and Managed Care staff in reference to technical system and application ... or trends. Pivots detail for distribution to assigned Contract Manager or analyst. Contributes to the development and implementation...and interim updates which may impact payers and products managed by other Managed Care … more
- AdventHealth (Maitland, FL)
- …Provides guidance and direction to PFS, Central Denials, Patient Access and Managed Care staff regarding contract terms and policies including; governmental ... the Florida division. This position assists the Sr. Contract Manager with ensuring that preferred contract language provides for...key contract data elements which are populated into the Managed Care database including addition of new… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- … whenever possible, and ensure evidence-based treatment is being applied. An experienced case manager with managed care experience will be successful in this ... Shield of Minnesota Position Title: RN Specialist Complex Case Manager - Oncology Location: Remote Career Area: Health Services...US Preferred Skills and Experiences * 2+ years of managed care experience; eg case management/health coach,… more
- Molina Healthcare (West Union, IA)
- …until they are discharged from your service. The ideal candidate will have experience as a Care Manager within a managed care organization (MCO) like ... JOB DESCRIPTION Opportunity for an experienced Care Manager who is Bachelors or Masters trained in a social services field to join the LTSS team with our Iowa… more
- Cardinal Health (Helena, MT)
- …for all lines of business including Medicare, Medicaid, and various commercial markets. The Managed Care Market Manager is responsible for maintaining the ... role is devoted to educating both customers and sales on managed care and enrolling prospective pharmacies into retail pharmacy solutions. **_Responsibilities_**… more
- Molina Healthcare (Carson City, NV)
- …QUALIFICATIONS:** + At least 7 years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health plan setting, ... integrity issues, and process gaps. + Applies understanding of healthcare regulations, managed care claims workflows, and provider reimbursement models to shape… more
- Molina Healthcare (Las Cruces, NM)
- …is an Equal Opportunity Employer (EOE) M/F/D/V. \#PJHPO Key Words: Medicare, Medicaid, Managed Care , Manager , Leader, Marketing, Duals, Enroll, Enrollees, ... **Molina Healthcare** is hiring for a ** Manager of Growth & Community Engagement** in southern...years' experience in business development, community relations or health care related activities. + 3 years Managed -… more
- AdventHealth (Maitland, FL)
- …strong organizational skills. The Medical Economics Manager will manage and mentor managed care staff for both the Florida and Multi-State Divisions of ... FL **The role you will contribute:** A Medical Economics Manager is responsible for overseeing the analysis and evaluation...financial and economic data related to healthcare costs and managed care payer rates and reimbursement. The… more
- Molina Healthcare (Dayton, OH)
- …integrity and other cost recovery processes + Direct PM experience in Managed Care Operations (claims, system configuration, provider data management preferred) ... and appreciates the member environments we serve + Exposure to all Managed Care industry functional departments **JOB QUALIFICATIONS** **Required Education** +… more
- Sea Mar Community Health Centers (Vancouver, WA)
- …education, and public health coverage case management. Under the direction of the Managed Care Manager and Coordinator, they pro-actively contact customers, ... #27077 Position Summary: Full-Time Customer Service Representative position available for our Managed Care department in Vancouver, WA. The Customer Service… more
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