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In conjunction with the VP of Managed Care Contracting & Payor Relations/legal department, reviews and negotiates any new 340B contracts and renegotiation of existing transaction fees. Participates in the policy and procedure development, maintains internal and external relationships (wholesalers, Covered Entities, and third-party administrator [TPA] vendors) as needed, 340B rules/guidance surveillance, assist in 340B off site audits as necessary, contract management/implementation, reporting/analyzing, and program enhancement/ optimization projects including annual budgeting.
$65,000 - $85,000 a yearFull-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Incorporates findings from the analysis of revenue streams and clinical programming to collaborate with the VP Finance in defining opportunities for revenue optimization through managed care contracting to ensure that we capture all available revenue opportunities and are appropriately compensated for our services.
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East Pavilion Surgery Center is a state-of-the-art ambulatory surgery center (ASC) jointly owned and managed by SCA Health. We are a fast-paced, high quality and safety centered outpatient surgery center that provides exceptional care to all patients, offering a tremendous work-life balance and boasting a culture that is employee and patient-focused.
$100,000 - $120,000 a yearFull-timeExpandApply NowActive JobUpdated 3 months ago - UpvoteDownvoteShare Job
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Case Manager must have minimum of two (2) years of case management experience assigned to Long-Term Managed Care Medicaid Waiver program and successfully complete all required trainings.
$20 an hourFull-timeExpandApply NowActive JobUpdated 2 months ago - UpvoteDownvoteShare Job
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Managed care, contracting, policies, and procedures. minimum three (3) years of healthcare experience in managed care. Role requires knowledge of health care, managed care.
$72,067.77 - $93,687.81 a yearExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Job Summary: The VP, House Calls is accountable for the day-to-day performance of all the clinical divisions (the primary, specialty, urgent care centers, nursing home, house calls) and support division (care management and managed service organization.
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Performance Management & Regulatory Compliance: Develop and implement performance metrics, monitor key performance indicators, and provide feedback to clinicians to improve productivity, efficiency, and quality of care in conjunction with the Quality Director and development and implementation of Quality Improvement Plan. Participates in the review of managed care performance data and implementation of corrective action as needed.
Full-timeExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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Job DetailsLevelExperiencedJob LocationBH-Mental Health - Detroit - Detroit, MIPosition TypeFull TimeEducation LevelGraduate DegreeTravel PercentageNegligibleJob ShiftDayJob CategoryNonprofit - Social ServicesDescriptionThe Quality Analyst has a comprehensive understanding of managed care and knowledge of county Quality Improvement procedures.
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Establishes individual resident plan of care, based on current evidence, to optimally address resident-specific goals and to comply with service delivery parameters in accordance with the Resident Assessment Instrument (RAI) Manual, Managed Care Contract or other guidelines specific to skilled nursing and rehabilitation.
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Supervises and directs PTA in the implementation of the treatment plan, Provides on-going guidance and consultation with the PTA to ensure optimal delivery of treatment interventions. Provides and directs high quality Physical Therapy services to residents, including screening, assessment, treatment, program planning and implementation.
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The DHS teams will be funded through a 5-year grant from the state-sponsored Housing Homeless Incentive Program (HHIP) and administered through the two largest Medicaid managed care plans (MCPs) in LA County: LA Care and Health Net.
$21.11 - $30.44 an hourFull-timeExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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Direct Support Professional, DSP, Mental Health Worker, Youth Counselor, Direct Care, Group Home, Residential Care, Human Services, Personal Care Assistant, The Residential Counselor is responsible for the daily implementation of activities and individual client treatment plans, and the development and maintenance of therapeutic relationships with individuals.
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Leads and creates the annual operating and capital budgets implementation of strategic/operational initiatives including but not limited to new services/programs revenue enhancement expense reduction managed care utilization systems and inpatient and ambulatory strategies for pharmacy care.
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3 plus years of experience in the pharmaceutical industry and/or managed care, including direct experience in HEOR. Experience in HIV and/or US managed care. Contribute to the development and implementation of the global HEOR strategy and programs to support the marketed and near-term pipeline assets.
$191,335 - $247,610Full-timeExpandUpdated 13 days ago - UpvoteDownvoteShare Job
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Continually monitors 340B regulations to ensure federal compliance, staying up to date on all rule changes, including HRSA/OPA, Medicaid and manufacturer changes. Responsible for managing all communications and relationships between KPH and all Covered Entities and their designated 340B TPA within the program.
$65,000 a yearFull-timeExpandApply NowActive JobUpdated 2 days ago
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