• CHRISTUS Health (Sulphur Springs, TX)
    …required to have a working knowledge of ICD9, CPT and HCPCS coding and managed care . Responds to incoming telephone calls and (per provider instructions) calls ... Summary: Under supervision, the incumbent of this position provides professional nursing care to clinic patients. Works collaboratively with the providers within the… more
    JobGet (11/26/24)
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  • System Director of Managed Care

    Fairview Health Services (St. Paul, MN)
    …ultimate accountability for effective and timely execution of all managed care contract negotiations and contract execution for hospital , physician and ... accountable for achieving budgeted net revenue expectations for all managed care contracts; assesses, evaluates, and directs... Management , elevates strategic and tactical decisions of managed care relationships to achieve alignment and… more
    Fairview Health Services (11/20/24)
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  • Manager Care Management , IHCI

    Community Health Network (IN)
    …years of clinical staff management experience in population management or managed care /insurance or hospital case management department setting ... Manager Care Management , IHCI Job Ref 2407866...Manager Care Management , IHCI Job Ref 2407866 Category Leadership Job...for this position will bring population health and value-based care clinical operations and care management more
    Community Health Network (11/26/24)
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  • Program Manager - Managed Care

    Cedars-Sinai (CA)
    …service the network's membership. + Monitors and Tracks all other aspects of Managed Care , quality & efficiency measures, Star ratings, access, physician network ... user or client acceptance. + Well versed within the various components that comprise Managed Care and its key concepts including but not limited to eligibility,… more
    Cedars-Sinai (11/07/24)
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  • Senior Contracts Administrator / Managed

    Hartford HealthCare (Hartford, CT)
    …**Hartford HealthCare Corp.* **Title:** *Senior Contracts Administrator / Managed Care Contracting* **Location:** *Connecticut-Hartford-100 Pearl Street ... on hospital , physician, behavioral health, skilled nursing, home health care , and rehabilitation with a solid understanding of reimbursement methodologies o… more
    Hartford HealthCare (10/23/24)
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  • Managed Care Case Manager RN…

    Trinity Health (Fresno, CA)
    care continuum for CVHP members. This includes discharge planning, utilization management , care coordination, and support for resource utilization. This ... professional agencies, familiarity with federal and state regulations governing hospital and home care , as well as understanding of the financial structure of… more
    Trinity Health (11/15/24)
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  • VP, Managed Long-Term Services and Supports

    UPMC (Pittsburgh, PA)
    …Health or a closely related field required. + A minimum of 5 years of management experience; preferably with managed care . + Experience with Medicaid and/or ... The Vice President has overall product ownership of the Managed Long-Term Services and Supports (MLTSS) program line of business, Community HealthChoices (CHC). In… more
    UPMC (11/09/24)
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  • Nurse Clinician: Prior Authorization: California…

    Molina Healthcare (San Bernardino, CA)
    …meetings. **Preferred Experience** 3-5 years clinical practice with managed care , hospital nursing or utilization management experience. Previous ... Care ). **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). Out of state candidates must work… more
    Molina Healthcare (10/17/24)
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  • MGB Internal Resource Pool RN- Nantucket Cottage…

    Nantucket Cottage Hospital (Nantucket, MA)
    …a complete continuum of care including community and specialty hospitals, a managed care organization, a physician network, community health centers, home ... innovation across our system. Founded by Brigham and Women's Hospital and Massachusetts General Hospital , Mass General...nurse is responsible and accountable for the overall nursing care management of a designated group of… more
    Nantucket Cottage Hospital (09/04/24)
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  • LVN or RN Clinician, Prior Authorization (Tuesday…

    Molina Healthcare (ID)
    …meetings. **Preferred Experience** 3-5 years clinical practice with managed care , hospital nursing or utilization management experience. Previous ... team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care , for… more
    Molina Healthcare (11/09/24)
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  • Leader, Contract Management

    Childrens Hospital of The King's Daughters (Chesapeake, VA)
    …is primarily responsible for fostering collaborative relationships with managed care organizations (MCOs). The Leader of Contract Management works closely ... or a related field is required. + 7-10 years of experience in managed care contracting, network management , or payer relations within an integrated… more
    Childrens Hospital of The King's Daughters (10/26/24)
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  • Manager, RN - In-Patient Hospital Case…

    Mount Sinai Health System (New York, NY)
    … personnel as needed. The Nursing Clinical Manager collaborates with Appeals Management , Managed Care Contracting and other institutional departments ... Life Saver (BLS) Issuing Agency: AHA Non-Bargaining Unit, 329 - Case Management - MSH, Mount Sinai Hospital **Responsibilities** 1. Attends interdisciplinary… more
    Mount Sinai Health System (11/19/24)
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  • Program Management I - Colorado Mental…

    State of Colorado (Denver County, CO)
    PROGRAM MANAGEMENT I - Colorado Mental Health Hospital - Ft Logan - Denver Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4738545) Apply  ... PROGRAM MANAGEMENT I - Colorado Mental Health Hospital ...individuals. Medical services, occupational therapy, neuropsychological-rehabilitation services, and trauma-informed care services are available for all patients throughout the… more
    State of Colorado (11/23/24)
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  • Patient Care Tech- Mother Baby- FT- Nights-…

    Penn Medicine (Philadelphia, PA)
    …by the healthcare team and patient. Individual birth plans and specific needs are managed individually while providing a standard of care that supports the ... Postpartum unit is located on 4/5/6 Preston at Pennsylvania Hospital . There is a complement of 18 private patient...and staff function as one unit. More acute postpartum care includes: - Pre-eclampsia management - Hemorrhage… more
    Penn Medicine (11/20/24)
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  • Nurse Care Manager / Cardiology

    Children's Hospital Los Angeles (Los Angeles, CA)
    …utilization management and/or discharge planning experience. Thorough knowledge of managed care , utilization management , discharges planning, and ... the top 10 pediatric hospitals in the nation, Children's Hospital Los Angeles (CHLA) provides the best care...the multidisciplinary team to develop and implement a case management plan to ensure quality patient outcomes, and customer… more
    Children's Hospital Los Angeles (11/22/24)
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  • Supply Chain Technician - Materials…

    ProMedica Health System (Adrian, MI)
    The Charles and Virginia Hickman Hospital will give our community its first-ever wellness destination. Our families and friends will have improved access to ... nutrition education, exercise resources and state-of-the-art care like they never have before. We offer over...58 acute cate beds in our new state-of-the-art regional hospital . Our campus also features an organic farm with… more
    ProMedica Health System (11/15/24)
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  • Hospital Medical Collections Specialist

    Robert Half Accountemps (Van Nuys, CA)
    …for managing Medicare managed care , commercial, PPO/HMO and Medical managed care . Responsibilities: * Conduct hospital billing and collection ... Description A Hospital located in the Van Nuys is looking...care , commercial, PPO/HMO, and Medical managed care * Appeals and denials management . *… more
    Robert Half Accountemps (11/10/24)
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  • Director, Care Coordination

    Omaha Children's Hospital (Omaha, NE)
    …disabilities. **A Brief Overview** Responsible for developing and maintaining an enterprise-wide care management / care transitions system to include acute, ... transitions that meet industry best practices. Provides oversight for care management across the care ...standard practices. + Ability to review, interpret and implement managed care contracts with third-party including governmental… more
    Omaha Children's Hospital (11/15/24)
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  • Care Manager

    Crouse Hospital (Syracuse, NY)
    …organizational and problem solving skills. Knowledge of third party payers and /or managed care principles. Salary Range: $80,000+ *Based on verified education & ... collaboratively with the multidisciplinary healthcare team to ensure the appropriate allocation of hospital resources while maintaining the quality of care . The … more
    Crouse Hospital (11/13/24)
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  • Corporate Director of Supply Chain, Account…

    Community Hospital Corporation (Plano, TX)
    …overseeing corporate-wide supply chain processes, cost-savings initiatives, materials management efficiencies, and contract negotiations for owned, managed ... and cost-effectiveness across the supply chain. MAJOR RESPONSIBILITIES: Account & Hospital Relationship Management : + Cultivate and maintain strong,… more
    Community Hospital Corporation (11/14/24)
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