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The Director, Payer Strategy and Relationships (PSR), is responsible for managed care policies, goals and objectives related to contract language and reimbursement, negotiation strategy, and payer relationships.
$62.51 - $90.64 an hourFull-timeExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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The Senior Recovery Coach works intimately within the new Managed Care environment, working to ensure medical necessity is evidenced in team members’ work while ensuring proper authorizations and documentation is provided for individuals in Managed Care Plans.
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Director, Sales and Marketing Responsibilities: Oversee all external and internal sales efforts to achieve sales goals by modeling current sales systems, including positive modeling of The Artis Way. Lead efforts through face-to-face referral development, including calling on physicians, hospitals, managed care facilities, and other referral sources, etc.
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Under the supervision of the Director of Managed Care Operations, the Provider Network Manager is responsible for the overall coordination of the contracts between the Detroit Wayne Integrated Health Network (DWIHN) and the assigned network providers.
$85,000 a yearExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Experience with Managed Care, Utilization Management, Prior Auth, and Benefits Management decision support in the Non-MSK, Non-Vascular Surgical Domains. This high-performing individual contributor will be responsible for serving as a National Solution M edical Director of the Surgical Solution (Non-MSK / Non-Vascular), leading the strategic implementation of improving the health of the people we serve, influencing product strategy and design and medical management approaches that impact healthcare quality, cost, and outcomes, and improving access to and usefulness of health improvement tools offered to our health plan customers and members.
ExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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The Virginian , an LCS managed community is seeking an experienced Licensed Practical or Registered Nurse with experience working with senior population within, our Memory Care neighborhood and Assisted Living neighborhoods.
$30 - $40 an hourExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Complies with all Managed Care Organization, Medicare, Medicaid, and HIPAA regulations and requirements at all times. Responsible for coordinating administrative, business and other operational activities such as, but not limited to, HR, payroll, A/P, scheduling direct service staff and resolving client issues in conjunction with the Agency Director.
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WHAT WE DO At Ageless Men’s Health we focus on safe and medically managed testosterone replacement therapy, weight management, skin care and concierge medicine to help our patients improve their overall health and wellness.
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QUALIFICATIONS & EXPERIENCE REQUIREMENTS Graduate of an accredited school of nursing; RN Valid RN license in the state employed Three years of experience in a long term care environment preferred Experience with the MDS/RAI process and/or case management preferred JOB RESPONSIBILITIES The MDS Nurse RAC (Resident Assessment Coordinator) reports to the Executive Director and is responsible for accurate and timely completion of mds assessments and coordination of the RAI process.
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10 years experience with CMS and Managed Care Contracts. Guidehouse is seeking a Director / (Associate Director) of Independent Dispute Resolution team. The Director will serve as the leader of a team of dispute resolutions representatives, arbitrators, and reporting and invoicing analysts.
$120,500 - $180,700 a yearFull-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Founded by Brigham and Women’s Hospital and Massachusetts General Hospital, Mass General Brigham supports a complete continuum of care including community and specialty hospitals, a managed care organization, a physician network, community health centers, home care, and other health-related entities.
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Under general direction of the Behavioral Health Services Assistant Director, to oversee a program of the Behavioral Health Services Department; to plan, organize, direct, and manage functional areas such as: mental health, alcohol and drug, children's services, adult services managed care, administration (including but not limited to personnel, budget, contracts, accounting, purchasing, and facilities) and/or other Department programs; and to do related work as required.
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The Care Continuum Director (CCD) will work cross-functionally with Sales, Marketing, Clinical and Key Accounts to drive business growth, develop strategic market development initiatives and secure commercial that align with key IDNs and strategic partnerships across the care continuum (e.g. Home Health, Managed Wound Care Centers, Long Term Care, Travelling Physician Groups, commercial health plans, and IT Vendors.
Full-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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All clinical & state regulatory supervision of support teammates (PTA) are to be directly managed with direct support from their Clinic Manager (CM), Regional Clinic Manager (RCM) & Director of Clinical Operations (DCO.
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Qualifications : Child Psychiatrist Board Certified with managed care experience. Medical Director, Children in State Custody (NM Licensed, Child Psychiatrist) Maintains licensure requirements for other states as assigned by senior medical director and CMO.
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