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Experience in developing and leading Population Health Management strategies within a health system or managed care organization, preferred. Ensure alignment of clinical services with cost-effectiveness and quality care.
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Expertise in managed care contracting, cost accounting, and service line profitability analysis. The hospital's comprehensive range of services includes a 24-hour emergency department, intensive care units, cardiac and vascular surgery, neurosurgery, comprehensive stroke care, orthopedics, oncology, maternity services, diagnostic imaging, outpatient surgery, and acute physical rehabilitation.
$250,000 a yearFull-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Excel, Word, Outlook and PowerPoint)You're great for this role if: Experienced in healthcare - provider engagement, Medicare, Commercial and Medi-Cal managed care systems Detail oriented and possess strong organizational skills in a fast-paced environment.
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Also, Medicaid (Fee for Service, Managed Care Organizations), Veteran's Administration (VISNs), TRICARE Regional Offices, Specialty Pharmacy & Pharmacy Benefit Managers, ACOs and other Integrated Delivery Networks (IDNs), advocacy, consumer, provider and treatment systems.
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This position reports to the Clinical Director and has direct input into the flow of the day, oversees utilization review with managed care organizations, and provides daily leadership and direction to the program staff, managing crisis situations effectively.
$115,000 a yearFull-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Demonstrated knowledge of managed care operations processes and managed care contracting, including Capitation and Risk Pool Management also required. Minimum of 3 years of medical management experience in a managed care setting.
$306,862.41 a yearFull-timeExpandApply NowActive JobUpdated 12 days ago - UpvoteDownvoteShare Job
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Senior Contracts Specialist will report directly to the Director, Managed Care Contracting. Manages and coordinates with applicable units to respond to requests for due diligence as it relates to managed care contracting for KCMG/USC Care provider expansion efforts and onboarding, as assigned.
$112,370 a yearFull-timeExpandApply NowActive JobUpdated 13 days ago - UpvoteDownvoteShare Job
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5 years of management level experience, including direct supervision of staff, in regulatory audits and/or internal audit and oversight for a Medicare/Medicaid managed care health plan required.
$290,011 a yearFull-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Under the direction of the Director of Finance – Post Acute Care Services, this is a management position responsible for Home Health and Hospice billing through final resolution of patients accounts to maximize collectible revenue and minimize outstanding discharged receivables.
Full-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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Minimum 10 years of previous experience working in HEOR and/or RWE outcomes research in the pharmaceutical, managed care or consulting industries. The candidate in this position will provide HEOR & RWE presentations, clinical presentations as necessary, conduct collaborative research, and enter into evidence-based medicine discussions with healthcare providers, RWE researchers, managed markets medical and pharmacy directors, quality improvement specialists, integrated delivery networks, and managed care formulary decision makers and consultant pharmacists, state Medicaid and Medicare decision makers, guideline developers and others.
Full-timeExpandApply NowActive JobUpdated 13 days ago - UpvoteDownvoteShare Job
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Assist providers with reimbursement issues within core classes of trade, primarily Medicare Part B, Medicare Advantage, and Commercial Managed Care (Regional Plans) The KAM works with his/her assigned Regional Director and Field Reimbursement Manager to develop a strategy and business plan that maximizes the opportunity in the territory.
Full-timeExpandApply NowActive JobUpdated 13 days ago - UpvoteDownvoteShare Job
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The PCC regularly coordinates referrals to the palliative care program, assures proper authorization for care, assures visits are scheduled as authorized and that documentation by care team is conveyed to PCPs and authorizing managed care groups.
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Supports the Senior Medical Director (SMD) in the development and implementation of managed care operational processes as necessary. Experience in both fee-for-service and managed care operations.
Full-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Managed by Oakmont Management Group, we provide exceptional quality, comfort, and care with five-star services and amenities. The Business Office Director is responsible for the administration of payroll and accounting control functions and procedures in accordance with company policies and procedures.
$32 an hourFull-timeExpandApply NowActive JobUpdated 26 days ago - UpvoteDownvoteShare Job
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GENERAL PURPOSE: The Director of Rehabilitation is responsible for internal departmental communication and operations, facilitating and coordinating patient care, and quality assurance. This includes, but is not limited to:Effectively managing key relationships with hospital therapists, physicians, key hospital staff, managed care providers, rehab suppliers, and other key referral sourcesContributes to the professional development of self and Rehabilitation staff.
Full-timeExpandApply NowActive JobUpdated 13 days ago
managed care director jobs in Montebello, CA
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