- Daiichi Sankyo, Inc. (Bernards, NJ)
- …creation and supply of innovative pharmaceutical therapies to improve standards of care and address diversified, unmet medical needs of people globally by leveraging ... study is executed according to the agreed project plan. Complete a study risk assessment and ensure mitigation and contingency measures are prepared and implemented.… more
- Highmark Health (St. Paul, MN)
- …is responsible for analyzing clinical data to assess potential stop loss and managed care claim liability, utilizing Case Management oversight techniques to ... Analyze clinical data to assess potential stop loss and managed care claim liability and utilize Case...in insurance industry with claim management + Experience with excess risk product and related claim management/cost… more
- AIG (Atlanta, GA)
- …Excess Casualty At AIG, we are reimagining the way we help customers to manage risk . Join us as the Actuarial - Excess Casualty to take on key ... Actuarial Our Actuaries are on the front lines, quantifying risk , pricing insurance and reserving losses for AIG's major...expertise to be a key leader on the Retail Excess Casualty team. The Actuarial Associate Director's main responsibility… more
- Ochsner Health (New Orleans, LA)
- …cost metrics and benchmarks. Provides focused direction and promotion of value-based care issues and initiatives, navigating across the numerous facets of the ... agencies to mitigate the significant regulatory, financial and operational risk of participation in the various programs. + Oversees...time) to move objects. Physical demand requirements are in excess of those for Sedentary Work. Even though the… more
- JPMorgan Chase (Jersey City, NJ)
- …Credit Management Standard, and operating model for managing transactional credit risk of non-Credit- managed /business- managed clients; oversees and drives ... excess of pre-defined thresholds. + Partners with Credit Risk Management, L&AS Data & Analytics program and Product...of the framework and operating model for managing credit risk of non-Credit- managed clients) and is accountable… more
- Ochsner Health (New Orleans, LA)
- …and participates in the reimbursement department's financial analysis, accounting, managed care analysis and reimbursement activities including preparation ... with Generally Accepted Accounting Principles (GAAP). Conducts analysis to support managed care contract negotiation, evaluates payer performance and contract… more
- Ochsner Health (Baton Rouge, LA)
- …and/or trauma upon the patient and their support system + Advanced knowledge of managed care and public programs such as those funded by Medicare, Medicaid, ... professionally to varying levels of individuals throughout the patient care process. + Good knowledge of common disease entities...time) to move objects. Physical demand requirements are in excess of those for Sedentary Work. Even though the… more
- PNC (Philadelphia, PA)
- …corporate obligors to provide investment opinions with a primary focus on adding excess return within managed portfolios through credit selection. The Senior ... manages over $14 billion in multi-sector fixed income separately managed accounts for a very diverse set of clients....total-return oriented with credit as a primary driver of excess return generation. Responsibilities: * Specialize in a fixed… more
- Ochsner Health (Lafayette, LA)
- …operations experience with specific focus in reimbursement Inpatient and Outpatient Managed Care and Commercial payors, Medicare and state/regional Medicaid ... experience with specific focus in reimbursement Inpatient and Outpatient Managed Care and Commercial payors, Medicare and...time) to move objects. Physical demand requirements are in excess of those for Sedentary Work. Even though the… more
- Kelsey-Seybold Clinic (Pearland, TX)
- …High School Diploma Preferred: Bachelor's Degree **Experience** Required: 3-5 years managed care experience in a call center/member services environment ... and KelseyCare Advantage members and providers with revenue in excess of $18 million to the organization. The supervisor...Extensive knowledge of plan benefits and various managed care products Excellent analytical and problem… more
- Ochsner Health (Gretna, LA)
- …Required - 5 years of experience in discharge planning, social services, home health, managed care , care management, case management or utilization review. ... through subsequent treatment and follow-up to reflect continuity of care . + Manages high risk , complex patient...time) to move objects. Physical demand requirements are in excess of those for Sedentary Work. Even though the… more
- Ochsner Health (New Orleans, LA)
- …and professionally to varying levels of individuals. + Excellent knowledge of managed care , CMS, Medicaid and other regulatory standards/requirements and ability ... the healthcare needs of the enrollee, identify barriers to care , develop a comprehensive treatment plan complete with specific...time) to move objects. Physical demand requirements are in excess of those for Sedentary Work. Even though the… more
- Ochsner Health (New Orleans, LA)
- …of the patient's movement through the healthcare system. + Proactively interacts with managed care / third party payers to obtain financial certification, to ... affect the patient. This job confirms a clear, specific care setting order by the physician and applies hospital...time) to move objects. Physical demand requirements are in excess of those for Sedentary Work. Even though the… more
- Ochsner Health (Slidell, LA)
- …your future today!** This job coordinates, negotiates, procures and manages the care of complex patients to facilitate achievement of quality and cost outcomes ... strategies to reduce length of stay and resource consumption for case managed patient populations. + Identifies appropriate patients for the various third-party… more
- Ochsner Health (New Orleans, LA)
- …anticipation of the patient's movement through the healthcare system. + Interacts with managed care / third party payers to obtain financial certification for ... with the patient, caregivers, multi-disciplinary team members, and post-acute care and third party payers. Confirms a clear, specific...time) to move objects. Physical demand requirements are in excess of those for Sedentary Work. Even though the… more
- Ochsner Health (New Orleans, LA)
- …and/or trauma upon the patient and their support system. + Advanced knowledge of managed care and public programs such as those funded by Medicare, Medicaid, ... personnel. + Advanced knowledge of an acute and chronic care medical setting, medical terminology and the psychosocial and...time) to move objects. Physical demand requirements are in excess of those for Sedentary Work. Even though the… more
- Ochsner Health (New Orleans, LA)
- …to high volume, fast paced clinical and office setting. + Dynamic knowledge of managed care and public programs such as those funded by Medicare (especially ... Nurse Case Manager or other members of the health care team. Performs duties under general supervision and following...Medicare risk products), Medicaid, and other payers 3rd party. +… more
- Ochsner Health (Lafayette, LA)
- …and/or trauma upon the patient and their support system. + Advanced knowledge of managed care and public programs such as those funded by Medicare, Medicaid, ... personnel. + Advanced knowledge of an acute and chronic care medical setting, medical terminology and the psychosocial and...100 pounds of force. Physical demand requirements are in excess of those for sedentary work. Reasonable accommodations may… more
- Guidehouse (Mclean, VA)
- …other materials summarizing service offerings and value proposition + Proven ability to achieve managed revenue goals in excess of $5m annually, as well as ... expectations management, performance management, succession planning, continuous improvement, and risk management. + Manage financial goals, costs, and risks with… more
- Ochsner Health (Lafayette, LA)
- …manner. Preferred - 1 year of management level experience. Experience in managed care , quality management, regulatory compliance, medical management, or other ... time) to move objects. Physical demand requirements are in excess of those for Sedentary Work. Even though the...care or first aid. There is no occupational risk for exposure to communicable diseases Because the incumbent… more
