- UpvoteDownvoteShare Job
- Suggest Revision
2+ years of experience in managed care OR medical insurance experience (can include credentialing providers, provider relations, medical billing, provider administration.
RemoteExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
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.
Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Three years' experience in a role that performs or supports provider credentialing, privileging, and/or enrollment in either a hospital, managed care plan or CMS environment is required.
ExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
- Suggest Revision
This is a part-time, fully remote position that can be located anywhere in the US. The mission of the California Department of Managed Health Care (DMHC) is to protect consumers' health care rights and ensure a stable health care delivery system.
Part-timeRemoteExpandUpdated 6 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Those contracts include managed care (FFS), value based, business support and delegated credentialing contracts with clients and payors, as needed. It has a direct impact on Montefiore Health Systems revenues since it is responsible for the implementation of multiple types of managed care, value based and client support contracts.
ExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Understanding of medical plan credentialing and provider enrollment. What we are searching for At least 5 years of managed care experience dealing with major Health Plans, PBMs MCOs, Third-Party Administrators (TPA) and other third-party plans or 5 years of PBM or Health Plan management experience preferred.
$131,200 - $183,640Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
The Worker will serve as a senior Business Analyst/Product Owner for the project of integrating the credentialing data used by Managed Care Organizations (MCOs) into the Provider Enrollment Management System (PEMS.
Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
2 years of progressively responsible experience in a business office or managed care credentialing setting with specific experience in provider enrollment. Provide documentation and prepare reports of provider data necessary for distribution to all payors, including Medicare Advantage and Managed Medicaid.
Full-timeExpandUpdated 3 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Under the supervision of the Director of Healthcare Revenue Cycle Management, the Credentialing Specialist’s overall responsibility is to ensure that the clinical staff maintains current credentials that enable them to work legally and performs all tasks necessary to ensure timely, accurate and reliable processing of healthcare staff appointments, reappointments, managed care enrollment, delegated credentialing, re-credentialing and managed care audits.
$60,000Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Under supervision of Director or Managed Care Contracting, works directly with Payors to negotiate contractual provisions and rates on behalf of HFHS Hospitals, Medical Group, Behavioral Health Services and other business units.
Full-timeRemoteExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Vetting of potential panel physicians recruited by Provider Recruitment and Credentialing (PRC). The Department protects the health care rights of more than 29.7 million Californians by regulating health care service plans, assisting consumers through a consumer Help Center, educating consumers on their rights and responsibilities, and preserving the financial stability of the managed health care system.
Part-timeRemoteExpandUpdated 6 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Ensures compliance with managed care contracts, county, state, and federal regulations for facility site reviews, medical chart reviews, provider credentialing, OSHA, OSHPD, HIPAA, FQHC, CLIA, etc.
ExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Work with revenue cycle team, credentialing team, and managed care contracting to work through Credentialing & Enrollment claim holds, denials and appeal processes. Certified Provider Credentialing Specialist (CPCS) and/or Provider Enrollment Specialist Certificate (PESC) preferred.
ExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Provides managed care training, educations and guidance and to manage provider/client communication efforts. Responsible for the timely production of New Member Welcome Packet to managed care members become eligible with NEMS within 30 days of enrollment, to meet timely completion requirement for IHA/HRA per CMS and/or DHCS standard.
Full-timeExpandApply NowActive JobUpdated 3 months ago - UpvoteDownvoteShare Job
- Suggest Revision
MetroPlus Health provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc.
ExpandApply NowActive JobUpdated Today
provider credentialing managed care jobs
FEATURED BLOG POSTS
Tips to Get Your First Job Confidently
Whether you’re a recent graduate or you still have a few exams left, you may be itching to put your polished leather shoes on and join the workforce. After all, your first job is an entryway into the professional life you’d lead for the decades to come.
Tips for a Good Character Reference Letter with Examples
Hiring managers love a resume laden with relevant skills and qualifications. Hard skills specific to the role, like SEO strategy or Java programming languages, are easy to qualify using achievements or facts and figures. But how exactly can they verify personality traits, work ethic, relationship management skills, or curious nature during an interview when they barely know you?
How to Dress on the First Day of Work (Men & Women)
You did it! Out of hundreds of applicants and dozens of people interviewed, you’re the one who got a new job. Congrats! Now comes the question of how to dress on the first day of work.
Why College Students Should Work While in College?
College is a special part of our lives. It’s a time when we prepare for our dream job while creating some of the most memorable moments in life. That said, college life can also be stressful. Not only do we have to spend long hours studying, writing and researching, but we also have to deal with increased tuition fees and living expenses.
5 Ways to Measure Candidate Experience
Your candidate experience is made up of 4 essential parts
How to Stall a Job Offer Politely
You did it! After several weeks of looking for a new job and undergoing grueling interviews, you finally have a job offer. Although this may be very exciting, accepting a job offer means that you’re making a long-term commitment to your future employer. So, even if you’re eager to leave your current job, this isn’t a decision you should take lightly.
How to Get a Job in a New City - Best Tips to Follow
When your dream job posts, will you be ready? What if that dream job was in a faraway city or a different continent…would you move for it? Most of us have dreamed about what it would be like to accept a job in a new place at one time or another. But when it comes to actually making a move, it’s usually the logistical details that give us pause. The key to job searching in a different location is to have a plan.