- Fallon Health (Worcester, MA)
- …Under the general direction of the Senior Manager, Clinical Quality, the clinical nurse analyst is responsible for developing and implementing the assigned ... Data and Information Set (HEDIS(R)) and MassHealth Appendix Q review. The clinical nurse analyst will provide clinical expertise and support for departmental… more
- New York State Civil Service (New York, NY)
- …as well as quality assurance issues; * Drug diversion investigations; * Managed care ; * Prior experience as a legal nurse consultant; and * Knowledge of ... No Agency Attorney General, Office of the Title Legal Nurse : Medical Analyst Support Medicaid Fraud Cases...Manager), including current or past employment within a long-term care facility; * Conducting investigations related to resident abuse,… more
- The Cigna Group (Bloomfield, CT)
- …through effective decision making + Experience in medical management and case management in a managed care setting is highly desirable + Knowledge of managed ... the treatment plan and goals, and identifies gaps in care or risks for readmission or complications. + Establishes...and providers **Summary description of position:** This position, the Nurse Case Manager Senior Analyst , through the… more
- The County of Los Angeles (Los Angeles, CA)
- SENIOR INFORMATION SYSTEMS ANALYST (Electronic Health Record) Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/3124187) Apply SENIOR ... INFORMATION SYSTEMS ANALYST (Electronic Health Record) Salary $106,081.08 - $142,953.84 Annually Location Los Angeles County, CA Job Type Full time Job Number… more
- Mount Sinai Health System (New York, NY)
- …+ Experience working in healthcare provider analytics related to revenue modeling, managed care contracting, population management, case management, clinical or ... **Job Description** The Data Science Analyst I collaborates with stakeholders from across the...is preferred in analytics development expertise, preferably in health care , or for a health provider, health plan or… more
- CVS Health (Columbus, OH)
- …as low risk. The Care Manager Specialist will work in conjunction with the Nurse Care Manager, Care Coordinator, Transition of Care (TOC) Coach, ... policies, procedures, and plans for the area. Consults with Nurse Case Managers, Supervisors, Medical Directors and/or other members...or CCM certification - Medicare and Medicaid experience - Managed care experience - Experience working with… more
- The Cigna Group (Nashville, TN)
- …RN License + Minimum 2-3 years clinical experience. + Experience in regulated managed care setting preferred + Strong Customer orientation + Strong ... Other duties as required **Qualifications:** + Current Licensed Practical Nurse LPN or Licensed Vocational Nurse LVN... practitioners and other health workers involved in the care of a member + Ability to meet deadlines… more
- CVS Health (Annapolis, MD)
- …stratified as low risk. The Care Manager will work in conjunction with the Nurse Care Manager, Care Coordinator, Transition of Care (TOC) Coach, ... COHN, or CCM certification + Medicare and Medicaid experience + Managed care experience + Experience working with geriatric special needs, behavioral health… more
- CVS Health (Tallahassee, FL)
- …stratified as low risk. The Care Manager will work in conjunction with the Nurse Care Manager, Care Coordinator, Transition of Care (TOC) Coach, ... COHN, or CCM certification - Medicare and Medicaid experience - Managed care experience - Experience working with geriatric special needs, behavioral health… more
- The Cigna Group (Bloomfield, CT)
- …analytical and problem-solving skills.** **Ability to work independently.** **Knowledge of managed care preferred. Effective coaching/education skills Ability to ... **The job profile for this position is Nurse Case Management Senior Analyst , which...**Experience in medical management and case management in a managed care setting is highly desirable.** **Knowledge… more
- The County of Los Angeles (Los Angeles, CA)
- …Develops and monitors revenue-generation procedures and objectives for programs managed , including achievement of revenue goals. Develops and implements reporting ... service delivery to ensure that services conform to acceptable standards of care and establishes and modifies program monitoring and review methods as necessary.… more
- Magellan Health Services (Hodge, LA)
- …related to assessing the efficiency, effectiveness and quality of the delivery of managed care services. Prepares monthly performance reports with audit results. ... overseeing contractual performance standards. Experience with reporting and analyzing managed care utilization data. Strong verbal and...and Certifications - Required BCBA - Board Certified Behavior Analyst - Care Mgmt, LCMFT - Licensed… more
- Louisiana Department of State Civil Service (Mandeville, LA)
- …options at varying costs. + Retirement Options for eligible staff This Registered Nurse 3 position is for a vacancy located in our residential facility, ... Below is a list of the pay range for the position: -Registered Nurse 3: $27.60/hour minimum - $49.66/hour maximum Note regarding the advertised pay range:… more
- Louisiana Department of State Civil Service (Mandeville, LA)
- …more about our agency, please Visit our website (http://fphsa.org/) This Licensed Practical Nurse 3 WAE position is for a vacancy located in our residential facility ... Below is a list of the pay range(s) for the position(s): + Licensed Practical Nurse 3 (WAE): $22.00/hour minimum - $29.13/hour maximum Incumbent may be asked to work… more
- HCA Healthcare (Denver, CO)
- …we are committed to caring for patients with purpose and integrity. We care like family! Jump-start your career as a(an) Procedural Operations Manager today with ... auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. + Free counseling… more