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10+ years of experience in managed care network development and provider relations/contracting management in a health care and/or managed care environment.
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For Carolina Complete Health plan: At least five (5) years of combined network operations, provider relations, and management experience; must reside in NC.Pay Range: $162,200.00 - $308,000.00 per yearCentene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.
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State Specific RequirementsVirginia: Must have at least one year of experience working directly with individuals with Substance Use DisordersPreferred EducationBachelor's Degree in NursingPreferred Experience years in case management, disease management, managed care or medical or behavioral health settings.
Starting at $23.76 - $51.49 an hour depends on education, experienceFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Milwaukee Ascension Hospitals include more than 40 clinic sites of care in Milwaukee as well as 7 owned hospitals averaging a bed size of 250-beds and 2 affiliated orthopedic hospitals, several skilled nursing facilities including the Alexian Village, ambulatory care facilities, home health care, physician practices, managed care services, and 4 cancer centers as well as standalone infusion sites.
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Typically requires 3 years of experience in behavioral health services that includes experiences in assessments, discharge planning and utilization review in a managed care environment.
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Shows working knowledge of managed care and Medicare health plans and reimbursement related to post-acute services within the continuum of care. is responsible and accountable for coordination of patient services through an interdisciplinary process, which provides a clinical and psychosocial approach through the continuum of care.
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Collaborates with the manager and/or insurance company to review referrals and/or pre-certification, policies, practice guidelines, denials, patient noncompliance, medical necessity, physician issues and other managed care issues as needed.
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Knowledge of insurance, managed care, PPO, FQHC billing, and Milwaukee County systems is preferred. High school diploma with at least two years of experience in healthcare, billing, and alternate payor reimbursement claims processing.
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When you join Ascension Medical Group (AMG), you are entering a community where physician and advanced practice provider engagement and experience are recognized as a key driver of delivering excellent patient care.
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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.
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We offer an energetic work environment with many corporate culture amenities, competitive salary, and rich benefit plan including: Medical, Dental, Vision, 401K, 529, Life Insurance, Income Protection Short and Long-Term Disability, Medical and Child/Elder Care, Flexible Spending Account Plans, Employee Assistance Program, Two weeks vacation, additional paid time-off for Personal and Sick, certification and hands-on training, and discounts for local event entertainment and health clubs.
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We provide primary care, specialty care, urgent care, emergency care, community health services, foster and adoption services, child and family counseling, child advocacy services and family resource centers.
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Responsible for timely and accurate billing of commercial, group insurance, Medicare, Medicaid, managed care, and self-pay home health and hospice accounts. Performs billing related services for Home Health Hospice programs, including the collection of Accounts Receivable, Notifications to Medicare, Medicaid, Commercial Insurance.
Up to $55,000 a yearFull-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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JobRelations: Reportsto: Sr Director of Revenue CycleManagement MainDuties and Responsibilities Responsible for timely and accurate billing of commercial, group insurance, Medicare, Medicaid, managed care, and self-pay home health and hospice accounts.
Up to $55,000 a yearFull-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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Knowledge of population health operations in managed care, including quality management, outcomes, provider network, claims, financial management, care management policies, disease state and population management, members’ rights and responsibilities, and the ability to quickly understand and assess program compliance.
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health of care managed jobs in Milwaukee, WI
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