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Provides backup to Managed Care Provider Enrollment Specialist. Liaison between Managed Care Director and CVMG, for Managed Care contract assistance and direction.
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Working knowledge of billing/coding terminology (i.e., ICD-10, CPT, Revenue codes); Procedural knowledge of hospital and physician practice accounts receivable managementIn-depth knowledge of payor contracting and negotiationWorking knowledge of privileging, credentialing, provider enrollment and managed care contracting requirements, practices, and industry standards.
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The Managed Care Coordinator supports the behavioral health inpatient programs by implementation or investigation of the procedures in the Utilization Review and Discharge Planning program at Westchester Medical Center.
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Resolves grievances, appeals and external reviews for one of the following VNS Health Plans product lines - Managed Long Term Care (MLTC), Medicare Advantage (MA), or Select Health. Develops and maintains current knowledge of state and federal regulatory requirements related to all aspects of grievances and appeals for Medicare managed care organizations, Medicaid, home health care, managed long term care as well as contractual requirements.
$93,400 a yearExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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The Clinical Operational Excellence Director (Managed Care Chief of Staff) Serves as a consultant providing strategic guidance, operational support, and facilitating communication across the business unit.
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NYC Health + Hospitals is the largest public health care system in the United States. At NYC Health + Hospitals, our mission is to deliver high quality care health services, without exception.
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LCSW/ASW, LMFT/AMFT required, current registration with Board of Behavioral Sciences
$75,000 - $85,000 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Working knowledge/experience of managed health care, admission pre-certification experience, and other insurance or fee for service programs. Use effective, clear communication to inform clearance (or non-clearance) of pre-authorization information obtained from managed health care to the potential client and other staff members as needed.
Starting at $18 an hourFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Working knowledge of lnterQual IS-SI, Milliman and Robertson Managed Care Guidelines, Erickson Life Skills (Age Competencies}, Medicare Part A and Part B, Medi-Cal, NCQA,HEDIS and other criteria as identified by the Quality/Case Management Department.
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Under the supervision of a Credentialing Supervisor/Manager, the Credentialing Specialist II is responsible for specific aspects of Credentialing and Recredentialing processing for a managed care organization, adhering to the National Committee for Quality Assurance, State and Federal regulations.
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Recommends the transfer to Managed Assets Department as appropriate per MSB credit policy. Manage the day-to-day operations of the Managed Assets Department (MAD) and the Bank’s OREO properties with the assistance of Department personnel.
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Compass Healthcare Consulting & Placement is conducting a search for an experienced RN Director of Staff Development and Education for a Managed Care Plan, MLTC, in New York. Position is in-office, located in the Bronx, NY. Qualified candidates will have NYS RN, BSN, prior MLTC, Managed Care Plan Care Management and UAS-NY experience, previous Supervisor or Manager level RN experience and previous experience in an Education or Staff Development role.
$160,000 - $180,000 a yearFull-timeExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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Assists in marketing and business development efforts with our existing state DOT clients while developing and overseeing a personal practice at Kimley-Horn that encompasses the planning, design, implementation, operations, and maintenance of managed lanes facilities and tolling systems/infrastructure.
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Our RDIWorks (RDIWorks.com) division is seeking a General Manager to lead our MSP (managed service provider) team. RDIWorks (RDIWorks.com) is a regional leader in the Midwest United States, providing IT consulting, network architecture/engineering, and managed services to businesses, government, healthcare, and education.
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The licensed vocational nurse (LVN) Managed Care Liaison (MCL) possesses those abilities that combine clinical expertise in community health with an understanding of the financial aspects of home care and aptitude for negotiation with third-party payor sources.
$28.81 - $47.53 an hourFull-timeExpandApply NowActive JobUpdated Today
managed care jobs Title: technician Company: Genoa Healthcare Company
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