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Advanced degree in medical/biosciences (i.e., PharmD, MD, PhD.) AND minimum 3 to 5 years related experience (field liaison responsible for market access , worked for managed care organization, corporate or field HEOR, etc.
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To support the AMG Workers Compensation Program, Atlantic Workers’ Compensation Covid Recovery Center, and to act as a liaison between all Atlantic entities and our Workers Comp Managed Care Partners/Workers Comp insurance carriers.
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Key Words: Billing, Claims, Reconcile, IHS, Indian Health Services, Tribal Liaison, Medicaid, MCO, Managed Care, Tribal, Value Added, Community, Tribal 638, Tribal Governments, TCBOs, HSD/MAD, Claims Examiner, Auditor, Claims Processor.
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Services; integrated health services; effective diversion to outpatient community-based programs; liaison with medical community; team consultation; integration of primary and behavioral health care; and promotion of quality assured managed care service system.
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Assisting in the development of government affairs and managed care presentations, act as a trainer to the MSL team for presentation delivery and be able to deliver presentations effectively.
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Serve as liaison between participants, physician investigators, sponsors of research, IRBs, CSHRI administration, patient care coordinators and insurance companies to assist in protocol interpretation, clinical and safety questions, and pre-authorization questions.
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May acquire insurance pre-authorization/referrals from managed care plans for all required services, admissions, procedures, diagnostic tests and medications. Knowledge of managed care plan requirements.
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Serves as liaison with the Office Manager, Practice Manager, physicians, and additional individuals responsible for coordinated customer care in order to achieve mission/vision goals. Covenant Medical Group is Covenant Health's employed and managed medical practice organization, with more than 300 top Physicians and providers spanning the continuum of care in 20 cities throughout East Tennessee.
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The incumbent will also act as a liaison with the BMLTC systems, technical assistance, and plan management units and externally with MLTC plan representatives to assure appropriate access and delivery of health services to Medicaid members receiving long term care service and supports.
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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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We are currently looking for a Care Navigator Nurse Liaison (RN) (CNNL) to join our team. Demonstrated knowledge and understanding of managed care organizations, including utilization review and capitated contracting concepts with hospitals and physician groups (physician billing, nursing home billing and hospice Medicare billing.
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The Director of Health Services is a position that is hired and managed by the Center for Developmental Disabilities Evaluation and Research (CDDER) at the Eunice Kennedy Shriver Center at UMass Chan Medical School that will be embedded in the Massachusetts Department of Developmental Services.
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Assist in establishing and maintaining liaison with appropriate community agencies and organizations, the TRICARE Lead Agent office, and the Managed Care Support Contractor. , MHS Genesis Patient Portal) to improve communication and facilitate care through non- traditional means.
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Appropriately uses available tools and resources to monitor and evaluate industry/managed care trends and communicate relevant information to those who are impacted (i.e. Sales Forces, Leadership, SFE Lead, Marketing and Market Access.
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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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