- UpvoteDownvoteShare Job
- Suggest Revision
Must have working knowledge of discharge planning, utilization management, case management, performance improvement, and managed care reimbursement. Specialized care includes orthopedic and surgical services, ICU, women’s services, a newborn nursery, comprehensive cardiovascular care from diagnostics to open heart surgery, vascular lab, sleep center, emergency services, the CHRISTUS Weight Loss Institute, wound care, rehabilitation, and more.
Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Departments and functions managed by each location include admissions, bursar, facilities, financial aid, IT, reception, and student accounts. Referral services for child, elder and pet care, home and auto repair, event planning and more.
Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
5+ years of managed healthcare experience, including 3 or more years in one or more of the following areas: utilization management, case management, care transition and/or disease management.
ExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Three or more years in Managed Care with experience in service coordination, medical and behavioral health utilization management, medical record review, discharge planning, data analysis, and case management of acute and chronic illness.
ExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Acts as point person within PACT Team. Assists in co-managed care collaboration with non-VA providers, and facilities. Consults as permitted by VAMC. Fulfill compliance requirements of the Office of Inspector General (OIG), Joint Commission(JC), Environment of Care (EOC) oversight, lab compliance and other related items.
ExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
- Suggest Revision
Broad knowledge of health care delivery/managed care regulations and experience with evidence based care guidelines (i.e. MCG/Milliman, Interqual). The PAC Nurse is a telephonic position responsible for recommending discharge plans, assisting with transition of care, and managing the length of stay (LOS) for Long Term Acute Hospital (LTACH), Skilled Nursing Facility (SNF), and Institutional Rehab Facility (IRF) for their assigned and non-assigned post-acute care (PAC) facilities through collaboration.
Full-timeRemoteExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
2+ years of experience with provider service/provider relations operations/managed care, or relevant experience preferred. Knowledge of health care, managed care, Medicare and Medicaid.
ExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Must have 5 years' experience in Health Care, specifically dealing with Managed Care Organization (MCO) claims and clinical data. Experience with Cognizant Product suite is a plus - QNXT, Clinical Care Advance, TCS, etc.
ExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Leadership position in managed care is preferred, with knowledge and understanding of utilization review and quality management procedures. Reporting to the Chief Medical Officer, this position provides clinical leadership and oversight of the population health management program including utilization management, case management, preventive health/disease management, and quality management while supporting the multidisciplinary member-centric approach to care management.
ExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Keep informed on issues and trends relating to Healthcare, Workers Compensation, Bill Review, Cost Containment, Managed Care, and related areas. Prepare legal/settlement assessments, manage litigation/bill disputes, respond to defense attorney requests, and provide testimony as an expert witness as required.
RemoteExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
- Suggest Revision
Board certified MD, DO, with an excellent understanding of network services and managed care, appropriate utilization of services and credentialing, quality assurance and the development of policies that support these services.
ExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
The mission of Correctional Managed Care is to address the healthcare needs of underserved patient populations within the Texas Department of Criminal Justice (TDCJ) and the Texas Juvenile Justice Department (TJJD.
ExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Adheres to required infection control, isolation procedures, and aseptic techniques in the deliver of patient care. Using the nursing plan of care in daily assignments, able to review and, under supervision, modify the plan of care.
ExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Bachelor's degree in Accounting or Healthcare related field with at least five years' experience in interpretation of Texas Medicaid Managed Care regulations, Texas Department of Insurance regulations, and/or HHSC OIG Medicaid Managed Care SIU regulations.
ExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Managed care orientation. Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short and long-term disability, Family and Medical Leave Act (FMLA), Group health and workers’ compensation claims.
ExpandApply NowActive JobUpdated Today
managed care jobs in San Antonio, TX
FEATURED BLOG POSTS
Recruiting in a Tight Market
As a recruiter or employer, you know how much the economy affects your recruitment and retention efforts. You aren't just in competition with companies in your industry, but you are also fighting against inflation, recession, unemployment rates, and so much more.
How to Build a Candidate Persona
A candidate persona is a semi-fictional representation of your ideal candidate. Building a candidate persona is one of the best methods employers use to ensure their sourcing, recruiting, and hiring processes are focused. Knowing exactly what you're looking for streamlines everything and helps increase hiring confidence. So here's how to create a candidate persona and how to use it.
How to Get Into The Trades: Step-by-Step Guide
Getting a trade job can be a great career move if you like variety and prefer to learn on the job instead of in an academic setting. A trade job can offer security and be a lucrative career path as the demand for skilled trade workers continues to grow.
How do Good Interviewers Prepare for Interviews?
Just like candidates take the time to research you and your company, you should take the time to prepare for the interview. Preparing for the interview doesn't just reflect well on your employer brand and create a better candidate experience. Preparation also helps prevent bad hiring decisions. Bad hiring decisions are usually a result of poor execution during the hiring process. However, going into an interview fully prepared and ready to evaluate candidates will help avoid bad hires. So, here are 6 interview preparation tips for employers.
How to Get a Union Job? A Step-by-Step Guide
A union job can significantly impact your job security, pay, and employment benefits. Whether this is your first job or you have years of experience, a union job can offer much-needed protection in a labor market where employees are hired and fired at will.
Should I Hire for Potential Over Experience?
The workforce is shifting every day. In fact, research from the World Economic Forum (WEF) shows over half of employees around the world will need to upskill or reskill by 2025. The rapid rise of digital literacy, automation, and new technologies will quickly supersede businesses that don't train ahead of the curve. With the dire need to invest in training, it's evident that hiring someone with experience isn't that much different than hiring someone without it.
How to Decide Between Two Job Offers: 10 Practical Tips
It’s arguably a good predicament to have. You’ve applied to many jobs, interviewed multiple times, and now find yourself with two legit job offers. Nice! But although this is a feel-good validation of everything you have to offer, a daunting choice lies ahead. How do you decide which job will be the best fit for you?