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The Managed Care Contract Analyst supports and is responsible for assisting the Assistant Vice President, Clinical Integration and Payer Contracting (AVP) in the administration of the FH value-based care (VBC) programs, both those held by the FH clinically integrated network (CIN), Frederick Integrated Healthcare Network (FIHN) and the FH employed medical group, Frederick Health Medical Group (FHMG) and the managed care contracts that are held by the Frederick Health entities included in FH.
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Further responsibilities include consulting with treatment team members, social brokerage, submission of Kepro managed care entries for Maine clients, clinical documentation, and discharge and transition planning.
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Provides hands on clinical or rehabilitation care ordered by the Eldercare physician on participants including but not limited to wound care, IV therapy, medication refills/teaching, diabetic care, physical or occupational therapy depending on the licensure of the Home Care Coordinator.
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Experience in scheduling and or care coordination in home care, geriatric care, workers compensation, managed care or other health care setting helpful. RN Home Care Coordinator (Hialeah.
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Our physician clients rely on Healix to handle all facets of infusion center operations, including drug purchasing, revenue cycle management, managed care programs, and clinical staffing.
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Five or more years of healthcare leadership and management experience with demonstrated ability in managed care contracting, practice transformation, Value based care performance tracking and systems change.
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Experience with Department of Mental Health (DMH), ACO (Accountable Care Organization)/MCO (Managed Care Organization), and or ACCS (Adult Community Clinical Services). The Clinical Care Manager will work collaboratively with the CCHP Behavioral Health team along with medical and behavioral health providers to coordinate clinical information for care management and coordination, care transitions, medication reconciliation and health and wellness coaching.
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Studies show that the physician office infusion center setting provides significant site of care benefits for patients, communities, and payors, including superior clinical outcomes and lower cost of care.
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The Care Coordinator will be Trilogy's clinical liaison to managed care organizations (MCOs), Integrated Health Homes (IHH), The Illinois Health Practice Alliance (IHPA), and will ensure compliance with The Healthcare Effectiveness Data and Information Set (HEDIS) measures.
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Compass Healthcare Consulting & Placement is conducting a search for an experienced RN Director of Staff Development and Education for a Managed Care Plan, MLTC, in New York. Position is in-office, located in the Bronx, NY. Qualified candidates will have NYS RN, BSN, prior MLTC, Managed Care Plan Care Management and UAS-NY experience, previous Supervisor or Manager level RN experience and previous experience in an Education or Staff Development role.
$160,000 - $180,000 a yearFull-timeExpandApply NowActive JobUpdated 15 days ago - UpvoteDownvoteShare Job
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Licensed Social Worker (LSW) or Licensed Professional Counselor (LPC) required ; Licensed Clinical Social Worker (LCSW) or Licensed Clinical Professional Counselor (LCPC) preferred. Meet deliverables based on MCO care coordination contracts and complete required reporting.
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The position is responsible for conducting regular meetings with providers, reviewing Assessments & Care Plans, providing guidance on clinical best practices, and assisting with escalation of cases that require additional assistance from L.A. Care. The position works directly with Care Management and Provider Network Management staff to inform Provider capacity-building and training activities related to the ECM Program operations.
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This center is managed by TRANSITIONAL CARE MANAGEMENT. We currently provide comprehensive management services to several inpatient healthcare centers throughout Northern IL & the Chicagoland area.
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An after-hours co-managed care clinical ARP is being developed for the Misericordia and Grey Nuns Hospitals. The Covenant family (Covenant Health, Covenant Care, and Covenant Living) provides acute care, continuing care and independent living services at 26 sites in 15 communities across Alberta.
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The mission of Correctional Managed Care is to address the healthcare needs of underserved patient populations within the Texas Department of Criminal Justice (TDCJ) and the Texas Juvenile Justice Department (TJJD.
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