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Deep understanding and experience with behavioral health strategy and operations in a managed care setting. Access: Ensure Humana members with behavioral health needs have access to appropriate and high-quality behavioral health care by optimizing network design, benefit design, care management, and referral pathways.
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As a Senior consultant, you will be working closely with health plan and managed care clients on a range of complex assignments. A minimum of five (5) years of prior work experience in healthcare, consulting, or the healthcare industry such as health plan finance, accounting, audit, managed care, or healthcare operations with a health plan focus.
$150,000 a yearFull-timeExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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Solid understanding of additional revenue cycle functions such as patient scheduling / access to care, care delivery & care coordination, patient flow / throughput, charge capture, managed care / contracting, revenue integrity, clinical documentation, and clinical / operational analytics coupled with proficiency with advanced consulting skills such as analytical, written, and verbal communication; possess appropriate client presence, facilitation and Executive presentation abilities.
Full-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Collaborate with internal J&J departments such as marketing, sales, medical science, SCG, IBG, HCC, and PECS. Serve as subject matter expert regarding education and insights on access and affordability solutions across multiple payer types and plans (i.e., Medicare, Medicaid Managed Care, Commercial.
$170,200 a yearFull-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Founded by Brigham and Women’s Hospital and Massachusetts General Hospital, Mass General Brigham supports a complete continuum of care including community and specialty hospitals, a managed care organization, a physician network, community health centers, home care, and other health-related entities.
Full-timeRemoteExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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10+ years of experience in the pharmaceutical industry, with experience in Managed Care, 340B and/or Finance preferred. Take good care of yourself and your family, with a wide range of health and wellbeing benefits including high-quality healthcare, prevention and wellness programs and at least 14 weeks’ gender-neutral parental leave.
Full-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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We process over 200,000 insurance claims annually for leading national and regional Workers' Compensation, Disability, Auto, and Group Health Carriers, Third-Party Administrators, Managed Care Organizations, Employers, and Pharmacy Benefit Managers.
$93,750 a yearFull-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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The Steward network includes more than 26 urgent care centers, 42 preferred skilled nursing facilities, substantial behavioral health services, over 7,300 beds under management, and more than 1.1 million covered lives through the company’s managed care and health insurance services.
InternExpandApply NowActive JobUpdated 20 days ago - UpvoteDownvoteShare Job
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Through our partnerships with health systems, hospitals, managed care organizations, and others, we continue to provide in-home care through the state’s first and largest Mobile Integrated Health program, SmartCare.
Full-timeExpandApply NowActive JobUpdated 19 days ago - UpvoteDownvoteShare Job
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The HHA/CNA will work as part of a self-managed team directly responsible for providing high quality care to our hospice clients in the Greater Boston area while being a constant companion striving to protect, nurture and sustain the client in a competent, caring and kind manner.
$23 an hourFull-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Reporting to MassHealth's Director of Enterprise Data Management and Engineering (EDME), as the Senior Program Manager, you will be responsible for leading SENDPRO. You will manage and oversee workstreams including internal development, testing, vendor management, and Managed Care Entity (MCE) communications.
Full-timeExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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Our growing ASC service line is part of the strategy team and works with providers across the country in all major aspects of the surgery business, including health system surgery site-of-service assessments, ASC strategic planning, surgery operations, ASC development, due diligence for mergers and acquisitions, managed care contract negotiations, and ASC feasibility studies, as well as the design of strategies that drive alignment and unity while being sustainable, scalable, and adaptable.
$176,000 a yearFull-timeExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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Provides interface with payers and managed care organizations through the completion of timely and effective reviews and necessary authorizations for initial authorization for individual therapy cases and as needed during vacation and any other absence by Part time Utilization Reviewer.
Part-timeExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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Communicates (verbally and in writing) with skilled nursing, assisted living, IDD, subacute and managed care organizations to assess market needs. PharMerica is the long-term care pharmacy services provider of choice for senior living communities, skilled nursing facilities, public health organizations and post-acute care organizations.
$72,000 a yearFull-timeExpandApply NowActive JobUpdated 21 days ago - UpvoteDownvoteShare Job
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Current working knowledge of discharge planning, utilization management, case management, performance improvement, and managed care reimbursement. The Nurse Manager for Ambulatory Medical Specialties is a Registered Nurse who functions as a patient care provider, supervisor and clinical resource for staff.
Full-timeExpandApply NowActive JobUpdated 14 days ago
managed care jobs in Brookline, MA
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