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Surgery Center at Cottonwood is a state of the art ambulatory surgery center (ASC) jointly owned managed by SCA Health. We have 2 operating rooms to provide patients with care in the areas of Orthopedic Surgery, Podiatry, Spine Surgery and Plastic Surgery.
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National Vision is hiring a Managed Care QA Auditor to join our growing team! Under the general direction of the Managed Care Operations Director, oversees the daily review of the integrity of data entered into required fields of the SDS system by Managed Care Reps during the billing, collections, and posting process.
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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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CareerStaff Unlimited, LLC ( CareerStaff ) is a renowned industry leader in healthcare staffing, managed services, and workforce solutions. CareerStaff Unlimited partners with companies around the country to raise the bar in healthcare by setting new standards for quality care and personalized service.
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Experience with payment methodologies including value-based care arrangements, risk based arrangements and other managed care models. Experience with population health, case management, or managed care.
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Focused on the population health management performance within the ACO and all other managed care payor populations. Oversees the monthly revenue cycle meetings with hospital admin and billing companies.
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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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The managed care pharmacist is responsible for performing various clinical duties related to utilization management of specialty (injectable) medications. Managed Care Pharmacist 5 - Population Health - P/T Days.
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Current working knowledge of discharge planning, utilization management, case management, performance improvement, disease or population management and managed care reimbursement. Understanding of pre-acute and post-acute venues of care and post-acute community resources, physician office routines, and transitional procedures for pre and post acute care.
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Familiarity with the Affordable Care Act, Mental Health Parity and Addictions Equity Act, 2016 Medicaid Managed Care Final Rule, Knox-Keene Health Care Service Act of 1975, electronic health care systems, CalAIM, Medi-Cal delivered specialty mental health services, and DMC-ODS delivery systems to address substance use disorders is highly desirable.
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Founded in 2007, we are a physician-owned and managed company, providing high-quality, cost-effective clinical management services across the full continuum of care in hospitals, critical care and post-acute facilities.
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7-10 years' experience in Healthcare Administration, Managed Care, and/or Provider Services. Experience with Medicaid and Medicare managed care plans. Serves alongside the VP, Health Plan Operations as liaison for MHI Operations, including: Claims, Configuration Information Management, Provider Data Management, Credentialing, Enrollment, and Contact Center Operations.
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Reproductive, managed/primary health care and/or abortion services experience desirable. Planned Parenthood of Orange and San Bernardino Counties has a full-time opportunity for an Ultrasound Technician / Medical Assistant in Anaheim, CA t o provide ultrasounds for surgical and non-surgical patients up to 24 weeks gestation as well as supporting functions in the delivery of reproductive health care, primary care and surgical services.
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Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management.
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The Behavioral Health Medical Director may speak with contracted external physicians, physician groups, facilities, or community groups to support regional market priorities, which may include an understanding of Humana processes, as well as a focus on collaborative business relationships, value-based care, population health, or disease or care management.
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