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Actively promote the CCM program in assigned facilities by partnering with key stakeholders (i e : internal sales function, provider relations, facility leader) to maintain and develop membership growth.
Full-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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For NPs: Graduate of an accredited master’s degree in Nursing (MSN) program and board certified through the American Academy of Nurse Practitioners (AANP) or the American Nurses Credentialing Center (ANCC), Adult-Gerontology Acute Care Nurse Practitioners (AG AC NP), Adult/Family or Gerontology Nurse Practitioners (ACNP), with preferred certification as ANP, FNP, or GNP.
Full-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Regular and effective communication with internal and external parties including physicians, members, key decision-makers, nursing facilities, CCM staff and other provider groups. Manage both medical and behavioral, chronic and acute conditions effectively, and in collaboration with a physician or specialty provider.
ExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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7-9 years in provider relations, payor contracting, provider enrollment, payor configuration or provider-facility credentialing Required. The Senior Payor Contract Analyst works closely with the Medical Affairs provider credentialing team, Revenue Cycle (including Hospital Physician Business Services, Coding, Patient Access, Reimbursement and other related departments), Finance department and external commercial insurance payor representatives.
$65,190 - $97,785Full-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Provider Relations Representative works as the primary liaison between Community First Health Plans and network participants (physicians, providers, and administrators) of the health plan provider network.
Full-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Understanding of medical plan credentialing and provider enrollment. Understanding and facilitating credentialing and enrollment requirements for each provider. Main responsibilities Provider network development: Individual will be responsible for promoting and selling services under current and future scope of pharmacy practice.
$131,200 - $183,640Full-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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The APC will do an initial medication review, annual medication review and a post-hospitalization medication reconciliation. As an CCM Nurse Practitioner/ Physician Assistant per diem you will provide care to Optum members and be responsible for the delivery of medical care services in a periodic or intermittent basis.
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The PNC ensures MSO network providers meet all credentialing and licensing requirements and is responsible for continuous monitoring of the entire provider network. 2-3 years work experience in healthcare setting in the areas of provider relations, claims, or utilization management is preferred.
ExpandApply NowActive JobUpdated 9 days ago - UpvoteDownvoteShare Job
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We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Serving millions of Medicare and Medicaid patients, Optum is the nation’s largest health and wellness business and a vibrant, growing member of the UnitedHealth Group family of businesses.
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The APC is responsible for ensuring that all quality elements are addressed and documented. As a team member of our Senior Community Care (SCC) product, we work with a team to provide care to patients at home in a nursing home, assisted living for senior housing.
Part-timeExpandApply NowActive JobUpdated 15 days ago - UpvoteDownvoteShare Job
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Sante Health System provides numerous client services such as billing, claims processing, contracting, credentialing, finance, human resources, information services, marketing/communications, physician services, practice management, provider relations, quality improvement, and utilization management.
$16 - $24 an hourFull-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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2+ years of experience in managed care OR medical insurance experience (can include credentialing providers, provider relations, medical billing, provider administration) 6+ months of medical claims experience (credentialing of a provider OR practice, HCFA forms (1500 Form), UB OR hospital claims forms, reimbursement claim forms.
RemoteExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Previous contracting, provider relations and/or provider reimbursement experience. Act as liaison between HFHS and Payors on contracting and operational issues, i.e. billing, utilization review, credentialing site visits, notification of site closures or new services.
Full-timeRemoteExpandApply NowActive JobUpdated 9 days ago - UpvoteDownvoteShare Job
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Understand the Payer/Plan benefits, CCM associate policies, procedures and articulate them effectively to providers, members and key decision-makers. Ability to lift a 30-pound bag in and out of car and to navigate stairs and a variety of dwelling conditions and configurations.
$40.87 an hourFull-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Act as a liaison to Provider Relations as a link between IEHP and individual physician, IPAs, medical groups, and hospitals. Chairperson/ Co-Chair of the HEDIS Improvement Committee, Quality Management Committee, Quality Improvement Committee, Credentialing Committee, Grievance Trend Committee k.
$240,676.8 a yearExpandApply NowActive JobUpdated 5 days ago
provider relations credentialing jobs
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