- Commonwealth Care Alliance (Boston, MA)
- …and drive both program-wide and provider -specific performance improvement. The LTSS Program Manager reports to the Senior Director of Delegation ... 011150 CCA-Network Contracting **Position Summary:** The LTSS Program Manager is responsible for...+ Serve as the primary liaison for assigned community-based LTSS provider organizations, with a focus on… more
- Commonwealth Care Alliance (Boston, MA)
- …and utilization management systems and workflows. - Experience managing delegated provider contracts and oversight programs. - Project management skills ... 011230 CA- Provider Engagement & Performance Position Summary: The Provider Delegation Performance Manager is responsible for overseeing and improving the… more
- Molina Healthcare (Warren, MI)
- …. * Identified as contract system lead by developing and maintaining provider contracts in contract management software. * Targets and recruits ... in the negotiation of medical group/IPA and hospital contracting. * Advises Network Provider Contract Specialists on negotiation of individual provider and… more
- Molina Healthcare (West Union, IA)
- 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 ... to determine the types of services we need to provide and managing their care until they are discharged...The ideal candidate will have experience as a Care Manager within a managed care organization (MCO) like Molina… more
- Elevance Health (KS)
- **RN Case Manager ( LTSS Service Coordinator- RN Clinician)** Location: Seeking candidates to reside in Montgomery, Elk, Wilson, and/or Chautauqua County Kansas. ... responsiveness to client needs, and direct, hands-on engagement. The **RN Case Manager ** is responsible for overall management of member's case within the scope… more
- Elevance Health (Arcadia, WI)
- **Title** : Manager II GBD Special Programs - LTSS Care/Service Coordination **Location: We are currently seeking people in the following counties:** Durand, ... an accommodation is granted as required by law. The ** Manager II GBD Special Programs** will be responsible for...for Wisconsin Family Care, a long-term service and supports ( LTSS ) program. **How you will make an impact:** +… more
- CVS Health (Harrisburg, PA)
- …with knowledge of basic negotiating skills. + Proven working knowledge of standard provider contracts , terms, and language. + High proficiency with Microsoft ... and meet network adequacy and expansion goals. + Audit, build, and load contracts , agreements, amendments, and/or fee schedules in contract management systems.… more
- Elevance Health (IN)
- ** LTSS Service Coordinator (Case Manager )** **Location:** Seeking candidates to work in Greene, Daviess, Martin, Dubois, Pike, Knox Counties in Indiana. ... responsiveness to client needs, and direct, hands-on engagement. The ** LTSS Service Coordinator (Case Manager )** is responsible... needs, as required by applicable state law and contract , and federal requirements. **How you will make an… more
- Centene Corporation (Mcallen, TX)
- …on topics such as preventive care, procedures, healthcare provider instructions, treatment options, referrals, prescribed medication treatment regimens, ... **License/Certification:** Licensed Behavioral Health Professional or RN based on state contract requirements: LCSW, LPC or RN with direct Behavioral Health… more
- Centene Corporation (Mcallen, TX)
- …on topics such as preventive care, procedures, healthcare provider instructions, treatment options, referrals, prescribed medication treatment regimens, ... **License/Certification:** + Licensed Behavioral Health Professional or RN based on state contract requirements eg, LCSW, LMFT, LPC and RN with BH experience… more
