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Florida Medical Clinic Orlando Health is an Accountable Care Organization. Florida Medical Clinic Orlando Health invites you to explore the Pathology opportunities with a thriving physician-led, professionally managed healthcare system.
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The C&S Plan Chief Medical Officer has accountability for ensuring that local health plan, United Clinical Services and UHC initiatives focusing on clinical excellence, quality ratings improvement, appropriate inpatient and outpatient utilization, health care affordability, health system transformation including provider network issues, mandated provisions and compliance, growth and focused improvement are implemented and successfully managed to achieve goals.
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Our practices offer Chronic Disease Treatment/Management, Women’s Health, Wellness, X-Ray/Ultrasound, Dental, Chiropractic, Urgent Care, Managed Care, and Workers Comp Services.
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Required QualificationsAdvanced degree in medical/biosciences (i.e., PharmD, MD, PhD.) AND minimum 3 to 5 years related experience (field liaison responsible for market access , worked for managed care organization, corporate or field HEOR, etc.
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In support of the Midwest Region Risk Bearing Entity (RBE) mission, vision, and strategic goals to achieve the quadruple aim by focusing on value-based care, the Network Medical Director provides clinical leadership in the adoption of the key principles, tools, technologies, and clinical support services essential to the population health management of their designated market(s.
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Collaborates in teaching clinicians and clinical operations teams about Medicare Risk Adjustment, Star ratings, and overall population health approach to patient care in both formal presentations and off the cuff at impromptu opportunities.
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Commercial and Medicare Advantage patient management (Value-Based Care) Our goal is to make an impact in the communities we serve through public health education, outreach, and our philanthropic endeavors that span beyond the doors of our facilities.
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Assists with managed care referral process, pre-authorization, and pre-certification processes. SJMHS represents more than 2,700 physicians and 14,000 nurses and staff, and includes 6 Hospitals, 5 Outpatient Health Centers, 8 Urgent Care Facilities and over 25 Specialty Centers.
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Trinity Health, one of the nation's top health care services providers, spanning five counties in Southeastern Michigan. Experience with managed care plans and the associated requirements of patient referrals.
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Knowledge of managed care, including risk adjustment, affordability, quality, utilization management, care management, quality. We're going beyond basic care to health programs integrated across the entire continuum of care.
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The Managed Care Coordinator will be supporting the Vascular Surgery Department at Beth Israel Deaconess Medical Center in Boston, MA.Job Description:Works collaboratively with primary care or specialty physicians, their patients and practices to coordinate and process managed care referrals and / or authorizations for patient care services, complying with BIDCO's and BIDMC's contractual rules for multiple managed care insurance payers.
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Knowledge of managed care, workers compensation and government reimbursement regulations, revenue cycle, medical billing and coding requirements. Knowledge of practice management and electronic health records systems applications and software; eClinicalworks software application preferred.
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We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. The Med. Dir. SUD/BH will report to the Market President and work closely with the Chief Medical Officer, Director of Population Health, and appropriate staff to ensure that AmeriHealth Caritas New Hampshire’s substance use disorder and behavioral health care management, utilization management and quality management programs comply with the terms of the State contract requirements and are supported by evidence-based practices.
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Our practices offer: Women’s Health, Wellness, X-Ray/Ultrasound, Dental, Chiropractic, Urgent Care, Managed Care, and Workers Comp services. At Family Care Partners of Northeast Florida, an InnovaCare Health company, we provide compassionate personalized care to patients of all ages.
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Department Managed Care Administration Job Summary Under limited supervision, the primary responsibility is in planning, implementing, and overseeing Quality Improvement (QI) projects and annual HEDISÂ medical record reviews, participating in annual Medical Record Review (MRR) training with successful completion of the certification exam, training staff, and conducting inter-rater reliability (IRR) and over-reads of QI staff throughout the medical record review process.
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health managed care jobs Title: medical in Suwanee, Georgia
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