- Highmark Health (Carson City, NV)
- …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
- Banner Health (Phoenix, AZ)
- …Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options ... 7. Collaborates with senior leaders and key stakeholders or experts, (eg, Clinical Risk Management, Care Management, including Patient Safety, Legal, etc.) to… 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 ... PNC Fixed Income manages over fourteen billion in multi-sector fixed income separately managed accounts for a very diverse set of clients. All portfolios are… more
- BlueCross BlueShield of North Carolina (NC)
- …to self-insured, commercial and Taft-Hartley health and welfare plans, managed care , provider network contracting, corporate law and risk management. + Prior ... law, other legal processes + Business acumen, including a well-developed understanding of managed care and the ability to diagnose corporate legal problems and… 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
- 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 (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
- Ochsner Health (Slidell, 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 (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
- Daiichi Sankyo Inc. (Basking Ridge, NJ)
- …creation and supply of innovative pharmaceutical therapies to improve standards of care and address diversified, unmet medical needs of people globally by leveraging ... according to the agreed project plan. Complete a study risk assessment and ensure mitigation and contingency measures are...unwarranted change orders) and budget, so both can be managed appropriately. + Provide oversight of the CRO to… more
- Ochsner Health (New Orleans, LA)
- …Exceptional health care business knowledge, including knowledge of, hospitals, managed care /insurance products, and industry trends. + Exceptional analytical ... time) to move objects. Physical demand requirements are in excess of those for Sedentary Work. Even though the...not called upon to perform or assist in emergency care or first aid. The incumbent has no occupational… more
- Ochsner Health (New Orleans, LA)
- …in nursing **Work Experience** Required - 7 years of case management experience in a managed care or acute care setting, including 3 years of leadership ... time) to move objects. Physical demand requirements are in excess of those for Sedentary Work. Even though the...not called upon to perform or assist in emergency care or first aid. The incumbent has no occupational… more