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Minimum requirement: 2+ years in the pharmaceutical industry, life sciences consulting or a managed care setting in the direct conduct of health economics, outcomes research, real-world evidence, and epidemiology studies.
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Experience with medical record review working on HEDIS/QARR in a managed care, health plan or provider office setting. Experience with medical record review working on HEDIS/QARR in a managed care or health plan setting.
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The managing editor is responsible for editorial direction, content, and tone of assigned journals in the managed care and population health vertical in both print and digital formats. We are currently seeking a Managing Editor, preferably with prior experience in Managed Care and peer-review.
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Familiarity with Ellucian Banner or other higher education student information system. Write and execute queries and API calls against university databases using SQL Server; data systems include Slate and Banner.
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At least 2+ years of RN Case Management experience in managed care MLTC. Qualified candidates will have prior RN Case Management experience within Managed Care, Home Care or Hospital Case Management, bilingual Spanish language ability required.
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Minimum three years, 2 years of experience in home care or hospital or home care registration or managed care coordination of services. A Baccalaureate Degree from an accredited college or university in Business Administration, Community Health, Psychology or related discipline with one year of full-time experience in a supervisory or administrative capacity in business management systems, general administration, health care and medical/patient systems administration.
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Under the direction of the Director of Admissions & Director of Utilization Review, the Utilization Review Specialist will coordinate Medicaid Managed Care benefits and approvals for clients receiving behavioral healthcare services from Odyssey House’s Part 820 residential programs.
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Job Overview – Wound Care Nurse Manager, MLTC (RN): Join our client’s team in Bronx, NY, as a Wound Care Nurse Manager for their Managed Long-Term Care (MLTC) program. Industry Knowledge: Excellent knowledge of Department of Health and Managed Long-Term Care standards required.
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OVERVIEW OF THE COMPANYFox CorporationUnder the FOX banner, we produce and distribute content through some of the world’s leading and most valued brands, including: FOX News Media, FOX Sports, FOX Entertainment, FOX Television Stations and Tubi Media Group.
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MetroPlus Health provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc.
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The LSC will be directly managed by the School Principal and coached by the Network Director of Student Support. The LSC will be directly managed by the School Principal and coached by the Network Director of Student Support.
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Position is Full- Time. Bilingual Spanish speaking with Homecare Experience; Exp. w/ HHA Exchange) Responsibilities: Conduct required on-boarding process for new hires (background checks; pre-employment physical; Home Care Registry Check) prior to start date.
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Clinical Support and Collaboration: Support OMH’s Hospital Care and Community Connections work to promote improved coordination of care and care transitions (including homeless, geriatric and rural issues), assist with OMH activities for the Medicaid Managed Care Program and other NYS regulated insurance programs and support mental health parity initiatives initiated by OMH. Support data driven implementation efforts led by the OMH Office of Population Health and Evaluation.
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Please note that this is a temporary contract position managed by DWT’s flexible contract attorney program, DWTSurge. Davis Wright Tremaine LLP is seeking an experienced construction and design contracts and litigation attorney for engagement through the firm’s alternative-track contract attorney and staffing program, DWTSurge.
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Join us in our mission to bring the best care to wherever our clients call home. At Home Health Care Inc., we're more than just a workplace - we're a supportive community dedicated to empowering our team members to thrive.
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managed care banner jobs Title: medical in Queens, NY
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