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Previous experience in creating and submitting managed care and/or Utilization Review state filings is preferred. PRIMARY PURPOSE: To support the Director of Utilization Review and Head of Managed Care and Clinical in the development and implementation of the internal Utilization Review program by completing all managed care and Utilization Review Organization filings in states throughout the country.
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AmTrust Financial Services, a fast-growing commercial insurance company, has a need for a Manager, Managed Care Filings in one of our offices in FL, TX, NY, CA, or IL. To support the Director of Utilization Review and Head of Managed Care and Clinical in the development and implementation of the internal Utilization Review program by completing all managed care and Utilization Review Organization filings in states throughout the country.
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Experience with medical decision support tools (i.e. Interqual, NCCN) and government sponsored managed care programs. Knowledge of utilization management principles and healthcare managed care.
ExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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Knowledge of Texas Medicaid (STAR, STAR Kids/CHIP) program, National Committee for Quality Assurance (NCQA), the Uniformed Managed Care Contract, and the Uniform Managed Care Manual.
ExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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They will act as a liaison to managed care companies, facilitating admissions, hospital returns, and referral source. Implements efficient processes to continually improve the flow of information to Clinical Liaisons, physicians, case managers, nursing, therapy and all departments involved in patient care.
Part-timeExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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They will support Regulatory, Sales, Marketing, Engineering, and Operations in the successful deployment and ongoing care and repair of emergency services. This position will lead the 911 Repair center, Network Diversity team, 911 Service Specialists, Customer premise equipment, and Tier 2 support for Frontier-managed emergency service hardware & software solutions.
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Exhibiting familiarity with healthcare compliance regulatory agencies and a general understanding of healthcare laws and regulations (e.g., HIPAA, CMS, Medicare, Medicaid, Affordable Care Act, Anti-Kickback, Fraud and Abuse laws, False Claims Act, Accreditation, Research and Academic Medical Center experiences); and.
ExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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10+ years of diagnostic laboratory or anatomic pathology physician sales and managed care contracting experience, The Managed Care Director manages and grows the payor contract portfolio to support continued profitable volume growth.
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Through an integrated technology and services platform, culturally competent provider network and personalized care model, Equality Health helps managed care plans and health systems improve outcomes for diverse populations while simultaneously making the transition to risk-based accountability.
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The Center for Cancer and Blood Disorders is seeking a BC/BE Fellowship Trained Breast Surgical Oncologist to join our extensive, well-established multi-specialty physician-led and managed group practice in Dallas/Fort Worth, TX.
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The Clinical Specialist is responsible for assisting LCS communities in the global implementation and training of the LCS clinical programs and protocols, benchmarks and standards, federal and state regulatory compliance and best practices in the delivery of quality care.
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With its owned/operated/managed venues , Live Nation Clubs and Theaters , a division of Live Nation Entertainment , is wide-ranging, including the legendary Fillmore venues and the intimate House of Blues clubs throughout the United States.
ExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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A working understanding and support of a managed care, full risk, value-based care model preferred. The provider will manage these patients with the supervision of the Neighborhood Center Medical Director in a multidisciplinary value-based care model.
Full-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Identify and document all patient accounts accurately based on what type of insurance product the patient has, PPO, HMO, other Managed Care Organizations, Medicare Advantage Plans, Government plans or Workman Compensation policies.
ExpandApply NowActive JobUpdated 11 days ago - UpvoteDownvoteShare Job
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The Center for Cancer and Blood Disorders is seeking a BC/BE Fellowship Trained Breast Surgical Oncologist to join our extensive, well-established multi-specialty physician-led and managed group practice in Las Colinas/Alliance, TX.
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managed care jobs in Dallas, TX
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