- Rady Children's Hospital San Diego (San Diego, CA)
- …HMO, Medi-Cal/Medicare and health services. Knowledge of principles and practices of health care service delivery and managed care , Medi-Cal eligibility and ... The PCC will identify and reduce barriers to members' care , assist the member in locating and accessing resources,...and educate the member on the importance of accessing care promptly. The PCC will serve as the primary… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …department, this position requires proficiency in English and Spanish.** JOB SUMMARY: The Lead Care Manager (LCM) operates a as a member of the patient's Enhanced ... Care Management (ECM) team and is responsible for coordinating...agencies or community service providers that are engaged in care coordination activities. The LCM will enroll patients in… more
- Rady Children's Hospital San Diego (Temecula, CA)
- …health condition(s), reinforce teaching, and/or provide coaching to sustain teaching and Care Plan from Care Management Team, and help patients/families develop ... patient families to adopt healthy behaviors. The CHW supports providers and the Care Management Team through an integrated, holistic approach to care management… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …diagnosis, family violence, child-protection, and bio-ethical issues - Experience working in an acute- care hospital setting - Registered as an ASW with the Board of ... family violence, child protection, and bio-ethical issues Experience working in an acute- care hospital setting Certification in Clinical Supervision in the State of… more
- Stony Brook University (Stony Brook, NY)
- …clinical and all potential medical interventions. + Demonstrates an understanding of managed care trends, payer regulations and Medicare/ Medicaid criteria for ... Training + Experience in Care Management + Experience in Managed Care /Insurance Industry/MD Office. + Certified in Case Management, UR, Quality or Risk +… more
- Optum (Dallas, TX)
- …Qualifications: Critical Care , Palliative, or Geriatrics experience Experience in a managed care setting and working with medically complex patients Working ... Optum NM is seeking a Palliative Care Physician to join our team in Albuquerque,...team in Albuquerque, New Mexico. Optum is a clinician-led care organization that is changing the way clinicians work… more
- Optum (Dallas, TX)
- …DEA license Preferred Qualifications: A working understanding and support of a managed care environment Compensation for this specialty generally ranges from ... Optum family of businesses, is seeking a Bilingual Primary Care Physician to join us in Tampa, FL. Optum...join us in Tampa, FL. Optum is a clinician-led care organization that is changing the way clinicians work… more
- Stanford Health Care (Palo Alto, CA)
- …of expected and actual revenue and contractual allowances for all payors including managed care , Medicare, Medi-Cal, commercial, and self pay payors. Oversee the ... and state filings. Work with other finance executives including VP of Managed Care and VP of Patient Financial Services to identify/optimize revenue enhancement… more
- Optum (Houston, TX)
- …ability to obtain prior to employment Preferred Qualifications 1+ years experience in managed care setting preferred Bilingual Spanish preferred Open to new ... is seeking a Full Time or Part Time Primary Care Physicians to join our team in Torrance, CA...Optum, we are transforming healthcare nationally while providing physician-led care locally. Work with the largest care … more
- Children's Hospital Los Angeles (Los Angeles, CA)
- …and utilization management and/or discharge planning experience. Thorough knowledge of managed care , utilization management, discharges planning, and continuous ... **NATIONAL LEADERS IN PEDIATRIC CARE ** Ranked among the top 10 pediatric hospitals...nation, Children's Hospital Los Angeles (CHLA) provides the best care for kids in California. Here world-class experts in… more
- Stanford Health Care (Palo Alto, CA)
- …area. + Knowledge of Medical Terminology such as Medicare, Medi-Cal, Workers Comp, Managed Care (HMO, PPO, POS, etc.), Children's Health Programs (CCS, GHPP, ... (United States of America) **This is a Stanford Health Care job.** **A Brief Overview** The Patient Access Services...coverage or existing financial resources to pay for medical care and services. Handles routine customer service inquiries and… more
- Stony Brook University (Stony Brook, NY)
- …hospital computer systems such as Life Image. * Knowledge of insurance & managed care requirements. **Special Notes** **:** **Resume/CV should be included with ... Radiology Patient Care Coordinator - Temp At Stony Brook Medicine the Patient Care Coordinator receives patients in the Radiology Department for exams and… more
- National Health Care Associates (Ridgefield, CT)
- …responsibilities + Thorough knowledge of Medicare, Medicaid, Pending, Applied Income, and Managed Care reimbursement regulations + Ability to manage multiple ... & Rehabilitation is a proud affiliate of National Health Care Associates. As a Certified Great Place to Work,...and that resources are optimized to provide the best care for our residents. **Key Responsibilities:** + Efficient and… more
- Commonwealth Care Alliance (Boston, MA)
- …experience in provider relations, network management, or healthcare operations within a managed care organization, health plan, or integrated delivery system. - ... vision and operational execution of provider relations for Commonwealth Care Alliance's SCO and One Care lines...for Commonwealth Care Alliance's SCO and One Care lines of business. This role is responsible for… more
- Commonwealth Care Alliance (Boston, MA)
- …management Desired Experience (nice to have): - Experience working with managed care organizations, value-based programs, or community-based behavioral health ... for BH providers, promoting alignment with CCA's mission and supporting high-quality, coordinated care for members. In this role, the Program Manager acts as an… more
- Commonwealth Care Alliance (Boston, MA)
- …Strong claims experience + Mentoring subject matter expert of the team + Managed Care experience (preferably Medicare/Medicaid) + Experience in health plan ... for building, maintaining and strengthening relationships with the Commonwealth Care Alliance's (CCA) diverse provider community - including physician, hospital,… more
- Commonwealth Care Alliance (Boston, MA)
- …**Required Experience (must have):** + 2 to 3 years Utilization Management experience in a managed care setting + 2 or more years working in a clinical setting ... record, and through official written notification to the primary care team, specialty providers, vendors and members in adherence...have):** + 2 or more years of Home Health Care experience + 2 or more years of LTSS… more
- Commonwealth Care Alliance (Boston, MA)
- …(must have):** + 5+ years of experience working within community-based health and/or managed care **Desired Experience (nice to have):** + Experience working ... can be shared with lower performing entities and with CCA's internal BH and Care Partnership teams + Determine regular cadence to check-in with lower performing HHs… more
- Commonwealth Care Alliance (Boston, MA)
- …Bachelor's Degree or equivalent experience **Experience (Required)** + 3-5 years + Managed Care experience + Experience in health plan provider relations. ... responsible for cultivating, maintaining and strengthening relationships with the Commonwealth Care Alliance's (CCA) provider community. In this highly visible field… more
- Harbor Health Services, Inc. (Mattapan, MA)
- …of health care resources, with attention to the quality and appropriateness of care within a managed care environment. Additionally, the Director of UM ... 5 or more years of management experience in a health plan and/or managed care environment required 3 or more years of supervisory experience preferred Knowledge… more
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