- University Health (Boerne, TX)
- POSITION SUMMARY/RESPONSIBILITIES Care Coordinator will be instrumental in assisting the department and clinicians in the Ambulatory setting by gathering ... managed group to enhance financial outcomes. Will coordinate the transition of care and the interdisciplinary treatment for Medicare managed patients across… more
- CVS Health (Columbus, OH)
- …Business Overview As part of the bold vision to deliver the "Next Generation" of managed care in Ohio Medicaid, OhioRISE will help struggling children and their ... in Ohio Preferred Qualifications Case management and discharge planning experience. Managed Care experience. Medicaid experience. Education Bachelor's degree or… more
- Trinity Health (Columbus, OH)
- …strong computer skills, including: Microsoft Office Suite and data entry Familiarity with managed care and claims processing required, including CPT & ICD-9 ... input of members hospitalized and precertification relating to medical care . The Coordinator acts as a liaison...coding, phone triaging, referrals and authorizations. Knowledge of managed care issues related to utilization management,… more
- Penn Medicine (Philadelphia, PA)
- …Maintains comprehensive knowledge of reimbursement coverage from third party payers, managed care plans and protocols for referrals. Additional Duties ... protocols Maintains comprehensive knowledge of reimbursement coverage from third party payers, managed care plans and protocols for referrals. Education and… more
- Penn Medicine (Philadelphia, PA)
- …timeframes. Maintains comprehensive knowledge of reimbursement coverage from third party payers, managed care plans and protocols for referrals. Ensures all ... is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field… more
- Penn Medicine (Philadelphia, PA)
- …timeframes. Maintains comprehensive knowledge of reimbursement coverage from third party payers, managed care plans and protocols for referrals. Ensures all ... is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field… more
- Penn Medicine (Berwyn, PA)
- …pertinent to patient service and billing procedures: including basic knowledge of all managed care plans and which insurers require a copayment or referral. ... is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field… more
- Centene Corporation (Raleigh, NC)
- …must reside in North Carolina. Ideal candidate will have experience in managed care quality . Education/Experience: Associate's degree in Nursing required; ... workplace flexibility. Position Purpose: Review medical records for potential Quality of Care (QOC) incidents, applying clinical criteria to determine if a lack of… more
- AmeriHealth Caritas (Newtown Square, PA)
- …understanding of Medicaid requirements, plan policies, and procedures. Familiarity with managed care principles. Our Comprehensive Benefits Package: Flexible ... Job Description: As part of the care coordination team, the Resource Coordinator ...to those who need it most. We offer integrated managed care products, pharmaceutical benefit management, specialty… more
- Penn Medicine (Philadelphia, PA)
- …with referral and copays, as appropriate. Maintains an excellent understanding of managed care plans and protocols for referrals, co-payments, and ... is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field… more
- Saint Francis Health System (Tulsa, OK)
- …health care , part of which may be experience in Behavioral health managed care . Knowledge, Skills and Abilities: Working knowledge of Microsoft Word, Excel ... matching the level of care utilization. Assures compliance with Managed Care Behavioral Health standards in the area of UM procedures and documentation… more
- Dana-Farber Cancer Institute (Boston, MA)
- …NCQA). Ensures compliance with appropriate accrediting and regulatory agencies. The coordinator assists with the development, planning and implementation of the ... process. Ensures that all expirables are reviewed, obtained, and managed on a monthly basis. Maintains the confidentiality of...in life changing breakthroughs in cancer research and patient care . We are united in our mission of conquering… more
- Sedgwick (Pittsburgh, PA)
- …adjustments, provider requests and operational expense check requests. Queues claims for Managed Care ; transfers payment allocations; and runs manual pre-pay and ... Place to Work Fortune Best Workplaces in Financial Services & Insurance OSS Coordinator PRIMARY PURPOSE : To support and maintain the claims management system for… more
- US Tech Solutions (Boston, MA)
- …Two plus years of experience in a business environment Preferred: Managed care /health industry environment experience. Skill Requirements Exhibits exceptional ... the computer system, and maintain proper documentation and files to support care of members, customer service, and other departmental functions. Enters all… more
- Cardinal Health (St. Paul, MN)
- …management preferred. Familiarity with Medicare, Medicaid, commercial insurance plans, and managed care preferred. Proficiency in billing software (eg Athena, ... and collect patient service revenue. The revenue cycle shadows the entire patient care journey and begins with patient appointment scheduling and ends when the… more
- Option Care Health (St. Paul, MN)
- …IG to include clinical, market, and payer dynamics Knowledge of reimbursement, managed care , and marketing Basic Qualifications Proven record of accomplishments ... clinicians as well as medical office staff (ie biologics coordinator ) to appropriately promote Option Care Health...(ie biologics coordinator ) to appropriately promote Option Care Health IG Complete +, share and interpret clinical… more
- Beth Israel Lahey Health (Winchester, MA)
- …experience. At least one year of experience with a healthcare or managed care organization necessary. Strong interpersonal, organizational and customer service ... referral database under the direction of the Performance Improvement Coordinator . Job Description: Qualifications Education/Experience Required: Associate's degree or… more
- Elderwood (Waverly, NY)
- Salary $ 20 / $ 22 Overview Managed Care Coordinator Overview Mon-Fri 8am-4pm The Managed Care Coordinator assists and supports the LPN/RN MDS ... team meetings at the discretion of the MDS Coordinator . Responsibilities Managed Care Coordinator Essential Job Fuctions + Able to successfully interact… more
- Beth Israel Lahey Health (Boston, MA)
- …you're not just taking a job, you're making a difference in people's lives.** The Managed Care Coordinator will support the ObGyn Department at Beth Israel ... Deaconess Medical Center in Boston, MA. The Managed Care Coordinator role is a hybrid work model, promoting a balance between on-site and remote work. Once… more
- Elevance Health (Bryson City, NC)
- **CFSP Managed Care Coordinator ** **Sign-on Bonus: $2500** **We are currently seeking people in the following counties and look forward to speaking with ... children and families thrive in safe, stable, and nurturing homes._ The **CFSP Managed Care Coordinator ** is responsible for the overall management of the… more
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