- KidsPeace Childrens Hospital (Old Town, ME)
- The Managed Care and Program Compliance Coordinator resolves managed care operational issues such as authorization for services, billing, and claims ... payment. Ensures all clinical operations comply with Medicaid guidelines and other managed care policies. Maintains managed care contracts and… more
- Spurwink Services (Lewiston, ME)
- …| Hourly | 21-27.50 per hour | Full Time Spurwink is looking for a Care Coordinator /Cultural Broker with strong skills to join our SHIFA ME Behavioral Health ... Homes Team in Lewiston. The Care Coordinator /Cultural Broker works across home, community,...Further responsibilities include providing updates on treatment progress for managed care entries, progress notes, and electronic… more
- Humana (Augusta, ME)
- …+ Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization + Knowledge of Medical Terminology and/or ICD-10 ... codes + Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization + Bilingual (English & Spanish) fluent in… more
- Humana (Augusta, ME)
- …+ Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization + Proficient utilizing electronic medical record ... caring community and help us put health first** The UM Administration Coordinator contributes to administration of utilization management. The UM Administration … more
- Cardinal Health (Augusta, ME)
- …independently with minimal supervision. + Strong organizational skills. + Understanding of managed care contracts and fee schedules, including Medicare and ... Coordinator , Benefits Eligibility and Authorization **_What Benefits Eligibility...that may need to happen to not delay patient care . + Complete any pre-service appeals to obtain paying… more
- Cardinal Health (Augusta, ME)
- …management preferred. + Familiarity with Medicare, Medicaid, commercial insurance plans, and managed care preferred. + Proficiency in billing software (eg ... building relationships of trust with customers and internal business partners. The Coordinator , Collections is responsible for the timely follow-up and resolution of… more
- Northern Light Health (Bangor, ME)
- …and timeliness of work impacts everyone involved. + Practices Compassion: Exhibits genuine care for people and is available and ready to help; displays a deep ... Northern Light Acadia Hospital is a broad behavioral health delivery system centrally managed from its location in Bangor, Maine. Acadia Hospital is a leader in… more
- Highmark Health (Augusta, ME)
- …degree + Pharmacy technician certification certificate + Experience working in a managed care medication formulary management environment + Working knowledge of ... retail pharmacy and/or third party prescription procession + Strong background and understanding of medications and formulary terminology + Pharmacy technicians must be familiar with multiple Medicaid drug benefit design offerings and rules/regulations across… more
- Option Care Health (Augusta, ME)
- …IG to include clinical, market, and payer dynamics + Knowledge of reimbursement, managed care , and marketing **Basic Qualifications** + Proven record of ... clinicians as well as medical office staff (ie biologics coordinator ) to appropriately promote Option Care Health...(ie biologics coordinator ) to appropriately promote Option Care Health IG Complete +, share and interpret clinical… more
- CVS Health (Augusta, ME)
- …country. **Position Summary/Mission:** As a vital member of our Special Needs Plan (SNP) care team, the Care Coordinator (CC) is responsible for coordinating ... about care management within Medicare and Medicaid managed care . + Familiarity with community resources...capable of utilizing these tools effectively in the CM Coordinator role. + Access to a private, dedicated workspace… more
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