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Founded in 2013, Innovista Health offers solutions for providers at every point along the continuum of value-based care, ranging from care management, provider/ACO enablement, and quality improvement to performance insights, reporting, and managed administrative/payment services.
Full-timeExpandApply NowActive JobUpdated 12 days ago - UpvoteDownvoteShare Job
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Functioning as a primary care provider, the provider shall request as indicated, consultations from specialists and subspecialists in the WTVAHCS staff. Provider shall see patients for general medicine problems including performing the history and physical exam, making electronic progress notes, scheduling return visits, writing orders for lab and x-ray, prescribing medications, etc.
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Partner with COL, credentialing coordinators and other key stake holders in onboarding and enrollment providers and facilities with Medicaid, Medicare, commercial and managed care plans.
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Communicate and collaborate with all Tempus commercial positions including VP Sales, Sales Leadership, Clinical Account Executives, Precision Medicine Partner Directors, Account Associates and Managed Markets teams.
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Bachelor's degree in Business, Finance or related field, plus 5-7 years of experience in the health care industry (at least 3 years in managed care contracting), or an equivalent combination of education and experience.
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Key stakeholder departments include, configuration, provider relations, provider credentialing, provider enrollment, claims, medical management and payment integrity. SUMMARY: The Provider Contracting Manager is responsible for leading or assisting with network development activities of commercial and government programs including: preparing contract proposals in accordance with financial, operational and quality objectives, drafting and negotiating contract terms, contract implementation and maintenance.
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Advise on managed care claims, third-party liability, Medicaid waiver programs, and provider enrollment. Extensive knowledge and practical experience in managed care claims, third-party liability, Medicaid waiver programs, and provider enrollment.
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Establishes and maintains liaison with CD, HSA, PSP, BHU-HQ team (RBHC, BHCC, BH Case Managers, BH Medical Assets Support Team), and other IHSC personnel (i.e., Field Medical Coordinator, Managed Care Coordinator, etc.
Part-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Evaluate and process credentialing for appointment of practitioners and follow credentialing standards of National Commission of Quality Assurance (NCQA) and The Joint Commission Standards, managed care requirements.
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Borgess Ascension Hospital includes more than 130 sites of care in 15 southern Michigan cities, as well as eight owned or affiliated hospitals, a nursing home, ambulatory care facilities, home health care, physician practices, managed care services, a cancer center and an air ambulance service.
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Supervisory Behavioral Health Provider works under the general supervision of the Clinical Director and receives Clinical supervision from the Regional Behavioral Health Consultant. Provides consultation to healthcare staff, custody staff, and ICE for housing recommendations including, but are not limited to, suicide risk management, PREA issues, care of Transgender individuals, and other cases of behavioral health-related specialized needs related to the care of detained non-citizens.
Part-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Our Onsite EAP Counselor is responsible for providing direct onsite clinical services at our customer's site in Covington, KY. As the world’s largest provider of EAP and Managed Care, this is an exceptional opportunity to use your clinical expertise to help support customer employees who are seeking EAP services.
Full-timeExpandApply NowActive JobUpdated 26 days ago - UpvoteDownvoteShare Job
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Eight (8) years of experience in a Managed care setting, with particular focus in value-based care models and population health (e.g., quality, efficiency, cost management). Six (6) years of experience in a Managed Care setting.
Full-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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The Commonwealth of Pennsylvania’s Department of Health (DOH), Division of HIV Disease, Care Section is seeking an IT Business Analyst / DBA to serve as a part of the CAREWare centralization project team, assisting the effort to migrate all provider data from their instance of CAREWare to the central DOH CAREWare server.
Work from homeExpandApply NowActive JobUpdated 13 days ago - UpvoteDownvoteShare Job
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Strong knowledge of Medicare, Medicaid, Managed Care and Commercial Plans Strong reconciliation and analytical abilities as it relates to medical billing, collections and payment posting Intermediate Excel experience Basic knowledge of clinical terminology, ICD-10, and CPT codes Ability to read and understand different Explanation of Benefits.
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