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As a hybrid Oncology Outpatient Pharmacist at the Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute in Los Angeles, California, you will be providing comprehensive direct patient care to leukemia, lymphoma, and other cancer patients.
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Experience in developing and leading Population Health Management strategies within a health system or managed care organization, preferred. Through close collaboration with other outstanding clinicians in our inclusive and engaging working environment, you can play a critical role in the delivery of our world-class care.
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Where applicable, responds to collection and audit requests timely from AR support departments i.e. CBO, Managed Care CBO Team, Accounting, Denials Department, etc. Completes month end close timely and accurately in coordination with the RFC and ARD. Coordinates monthly Triple Check with the facility Team, and ensures billing is compliant with State and Federal regulations.
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With 40+ years of home medical equipment sales experience, South Bay has proven relationships with the largest Managed Care Organizations (MCOs) and physician networks in the region.
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CT Assist is seeking a Nurse Practitioner Critical Care/Intensive Care for a locum tenens job in Long Beach, California. We were founded and are managed by active and former cardiac staff, which means we know the needs, the skills, and the challenges of cardiac and critical care staffing.
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Promotes compliance with and adheres to all regulatory and quality standards including but not limited to: Centers for Medicare and Medicaid Services (CMS), Department of Managed Health Care (DMHC), Department of Health Care Services (DHCS), and accreditation bodies’ standards such as the National Committee for Quality Assurance (NCQA) as it relates to Care Coordination activities.
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Work compliantly in a matrix environment encompassing Patient Services, Specialty Infusion Pharmacies, and Managed Markets, which includes treating confidential patient information in accordance with Kyowa Kirin practices and policies.
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Join us at Central California Alliance for Health (the Alliance) is an award-winning regional Medi-Cal managed care plan that provides health insurance for children, adults, seniors and people with disabilities in Mariposa, Merced, San Benito and Santa Cruz counties.
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We staff all four major divisions of acute care – nursing, lab, radiology, and rehab therapy One point of contact for both travelers and facilities (per division) In-house compliance and accounting specialists On-staff clinical liaisons Mentoring program that is run and managed by actual clinicians – yeah, you read that right And more (because of course there’s more) Are we the biggest.
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Requires 3-5 years Care Management experience in a health plan or other managed care setting. The ideal candidate must possess extensive care management experience and be a subject matter expert in compliance and regulatory requirements, particularly with a strong understanding of CMS Model of Care (MOC) requirements as it pertains to NCQA standards.
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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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2+ years Medicare, Medicaid, managed care or other health/insurance related sales experience. Develop sales strategies to procure sufficient number of referrals and other self-generated leads to meet sales targets through active participation in community events and targeted community outreach to group associations, community centers, senior centers, senior residences and other potential marketing sites.
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SCAN Group is the sole corporate member of SCAN Health Plan, one of the nation’s leading not-for-profit Medicare Advantage plans, serving more than 270,000 members in California, Arizona, Nevada, Texas and New Mexico.
$147,800 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Minimum of three (3) to five (5) years of experience in contract negotiation, managed care, healthcare administration, with at least three (3) years of direct experience in Medicare/Medi-Cal contracting required.
$135,000 a yearFull-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Experience with the handling of claims in a managed care business (HMO) Knowledge of claims processing rules, managed care benefits and adjudication. Claims processing to ensure quality (in/out patient hospital claims, Medi-cal, Commercial, and Medi-care claims.
$32 an hourFull-timeExpandApply NowActive JobUpdated 5 days ago
care in managed jobs in Torrance, CA
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