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Resolves grievances, appeals and external reviews for one of the following VNS Health Plans product lines - Managed Long Term Care (MLTC), Medicare Advantage (MA), or Select Health. Enters data and assists with compiling reports and analysis on the grievance and appeals process.
$93,400 a yearExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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In conjunction with IST managed services providers, performs various levels of system analysis and provide objective feedback/recommendations to Agency leaders. Oversees and provides direction and decision making for IST functions during department / agency crisis, under guidance of MSP managed services provider.
$29.98 - $34.71 an hourFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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The 12 states we serve are locally managed by a regional director and team of BCBAs∯*∯ Our corporate office located in Deerfield Beach, Florida is home to our leadership team and administrative staff who assist with daily operations, including client services, human resources, talent acquisition, finance, revenue cycle management, quality assurance, compliance, professional development, and professional ethics.
$30 - $38 an hourFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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We have a long history of improving the lives of children and families affected by autism spectrum disorder through our family-centric applied behavior analysis (ABA) approach. We will give you the opportunity to grow towards gaining your Registered Behavior Technician (RBT) and then Board Certified Behavior Analyst (BCBA) with guidance and financial assistance.
$19 - $24 an hourPart-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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The ideal candidate will possess a strong background in managed care, clinical trials, data analysis, and system design. Proficiency in Microsoft Office Suite and electronic medical records (EMR) systems.
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There are two satellite census research data centers at USC and UCI but managed by the Assistant Director through CCRDC. At CCPR the Assistant Director oversees operations of five infrastructure cores with a total combined faculty, graduate students, postdoctoral scholars, and staff of approximately 200.
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The Strategic Sourcing Manager Hotel Operations will execute strategic sourcing activities develop category strategies and manage spend programs designed to maximize the department's contribution to the company meet present and future demand identifying additional managed spend categories, manage vendor relationships and communications, drive cost savings and demonstrate a sense of urgency to prioritize work and solve problems by identifying solutions that last.
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Experience: Five years of experience in healthcare reimbursement, general ledger, payroll, internal audit, budgeting, revenue cycle, financial analysis, managed care contracting, information systems, debt financing, and materials management required.
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Proficiency in contract management systems (e.g., Salesforce CPQ, Model N, iCyte), ERP systems (e.g., SAP, Oracle, D365), and Microsoft Excel for data analysis and reporting. Expectations include managing data validation processes with internal team and external vendors, adjudicate rebate and formulary validation processes accurately and before payment deadlines, oversee payments of managed care and government rebates, and manage Market Access payments including purchase requisitions, purchase orders, and ACH funding for copay programs.
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Strong understanding of Financial Planning & Analysis, Enterprise selling processes, IT, and Managed Services Provider solution selling. Managed Mobility Services, Mobility Device Management, and Telecom Expense Management experience strongly preferred.
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Conduct RFP analysis to assist in determining award scenarios based on identifying the best supplier to provide the right product, quality, price and food safety. Responsible for data management and analysis by reviewing and ensuring that thorough financial, spend, supplier and market analysis are completed for all sourcing projects.
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Certification in Managed Care Nursing (CMCN) or Case Management (CCM) preferred. Experience with software systems, data analysis, data management associated with systems evaluation, clinical research, and analysis tools and methodologies preferred.
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Experience in quantitative research applied to at least one of these topics: Medicaid policy, healthcare performance improvement, population health, social determinants of health, healthy equity, managed care, or health administration, required.
$100,000 - $135,000 a yearFull-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Coordinates and ensures Antibiotic Stewardship Programs is properly managed in coordination with consultant pharmacist and physician. Oversee Employee Health program to ensure compliance with regulations, annual influenza immunization program, new hire health evaluation and immunization program, injury prevention and treatment and trend analysis of communicable disease exposure.
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Requires BA/BS degree in Mathematics, Statistics or related field and a minimum of 7 years experience in broad-based analytical, managed care payor or provider environment as well as in depth experience in statistical analysis and modeling; or any combination of education and experience which would provide an equivalent background.
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