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It offers four categories of products: Employer Stop Loss, Group Captives, Managed Care (including HMO Reinsurance and Provider Excess), and Specialty Accident. Berkley Accident and Health’s two primary office locations are Marlborough, MA and Hamilton Square, NJ, and the company underwrites Stop Loss coverage through Berkley Life and Health Insurance Company, rated A+ (Superior) by A.M. Best. For more information, please visit.
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At least five (5) years of experience in managed care network management with demonstrated experience managing a behavioral health provider network. The Behavioral Health Quality Management Supervisor shall report to the ABHNJ Quality Management Director and will work in close partnership with the ABHNJ Behavioral Health Medical Director, Behavioral Health Administrator, CMO, Behavioral Health Director of Network Relations and all matrixed growth partners to effectively manage access and quality of behavioral health benefits and care.
$40,600 - $89,300Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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To account for various G to N Deduction (Co-pay, Managed care rebates, DSA fees, Chargeback, Medicaid. To account for various G to N Deduction (Co-pay, Managed care rebates, DSA fees, Chargeback, Medicaid.
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Additionally managed care experience, reimbursement and clinical expertise desired, as well as a strong understanding of Specialty Pharmacy. The Sales Training Manager is primarily responsible for the successful development, delivery and management of customized training programs for each assigned contract.
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Broad knowledge of Medicare, managed care, third party payers, and Medicaid required; knowledge of Medicare rulemaking process, Durable Medical Equipment benefit category preferred. Conduct Medicare, VA, and Medicaid payment policy research and analysis, develop strategic recommendations.
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Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management.
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Requires strong knowledge of managed care principles and concepts including Health Plan Effectiveness Data and Information Sheet (HEDIS). Prefer a minimum of one (1) year experience in the managed care industry.
$54,600 - $73,080 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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MedUS Healthcare is seeking an experienced Intensive Care Unit Registered Nurse for an exciting Travel Nursing job in Trenton, NJ. Shift: 3x12 hr nights Start Date: 05/21/2024 Duration: 9 weeks Pay: $2576 / Week.
$2,576 a weekExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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Coordinates the delivery of high quality, cost-effective care based on the members- needs and the managed long term support and services model supported by clinical practice guidelines established by the plan.
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Knowledge of terminally ill patients and their families along with understanding of hospice concept; knowledge of roles of all disciplines providing hospice services; excellent patient assessment skills; good oral and written communication; thorough knowledge of managed care principles, regulatory guidelines (i.e., Medicare, Medicaid, and human resource) management principles.
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No managed care and no time spent on the phone arguing with insurance companies. A good knowledge of lipid management, cardiovascular risk, obesity, metabolic syndrome, stress management and lifestyle-related issues is helpful.
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Requires strong working knowledge of managed care plans, insurance carriers, referrals and precertification procedures. Our mission has always been to deliver excellent medical care with compassion.
$19 - $23 an hourExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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The ideal candidate will have proven experience as a field sales representative (in healthcare is a plus), have previously built and managed a book of business, and have a history of exceeding sales and client acquisition targets in the past.
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Maintains a schedule of primary sources including business, industry, EAPs, managed care of clients, physicians/licensed practitioners, and allied health professionals. The Business Development Representative is responsible for growing the facility's lines of service and levels of care as defined by management by developing and retaining referrals from professional referral sources across various account types.
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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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managed care jobs in Lawrence, NJ
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