- City of New York (New York, NY)
- …state managed care enrollment broker for the managed care program ) to ensure the operational integrity of MAP's managed care program ... to function as the Executive Director, of the Office of Mail Renewal, Managed Care Program (MCP), and Third-Party Health Insurance, who will: Under the… more
- WTW (New York, NY)
- …across our two business segments, Health, Wealth and Career and Risk and Broking. The Managed Care Growth Leader is the primary client lead managing the totality ... of the Willis Towers Watson (WTW) relationship for clients within the Managed Care Industry. This individual is accountable for profitable Managed Care … more
- Cedars-Sinai (CA)
- …healthcare people throughout Los Angeles and beyond. **Req ID** : 5668 **Working Title** : Program Manager - Managed Care (Hybrid) **Department** : MNS ... **Job Description** The Program Manager is responsible for supporting all facets...membership. + Monitors and Tracks all other aspects of Managed Care , quality & efficiency measures, Star… more
- Hartford HealthCare (Hartford, CT)
- …**Hartford HealthCare Corp.* **Title:** *Senior Contracts Administrator / Managed Care Contracting* **Location:** *Connecticut-Hartford-100 Pearl Street ... collaborative internal relationships across the system working with Revenue Cycle, Revenue Integrity and other HHC entities to provide updates and clarification on… more
- S&P Global (Nashville, TN)
- …the Role:** **Grade Level (for internal use):** 07 **The Team:** S&P Global Managed Data Services aims to provide the highest level of accuracy, visibility, and ... work within the Private Capital Markets. The Associate for Managed Data Services works within a team environment to...critical insights that truly make a difference. **Our Values:** ** Integrity , Discovery, Partnership** At S&P Global, we focus on… more
- S&P Global (Nashville, TN)
- …Level (for internal use):** 08 **About the Role:** **The Team:** S&P Global's Managed Data Services team leverages market-leading technology and a global team of ... financial reports + Perform controls to ensure accuracy and integrity of data + Collaborate with various internal parties...our customers to achieve shared goals. **Benefits:** We take care of you, so you can take care… more
- New York State Civil Service (New York, NY)
- …Office Suite and ability to learn new data systems.Familiarity with the Medicaid Managed Care /Family Health Plus/HIV Special Needs Plan Contract and other ... federal and state laws and regulations that govern Managed Care Organizations. Duties Description New York...the nation in developing a robust culture of Medicaid program integrity and healthcare compliance. Formed in… more
- Houston Methodist (Katy, TX)
- …competency and professional pathway progression. + Communicates updates/changes to processes, managed care information, throughput, etc., in a timely manner. ... with the ability to manipulate large amounts of data + Familiarity with managed care terminology and payor adjudication such as Inpatient/ Outpatient Prospective… more
- LA Care Health Plan (Los Angeles, CA)
- …organizations and business partners. At least 1 year of experience in leading program /project teams. Preferred: Managed care experience. Skills Required: ... Care Management Initiatives Program Manager II... (MOC). This position is a role model for integrity and establishes and maintains effective professional work relationships,… more
- Molina Healthcare (NE)
- …experience and demonstrated success in relevant Clinical Review Programs * 5+ years Managed Care payor experience, preferably Medicare / Medicaid experience * ... **Job Summary** The AVP, Clinical Validation (PI) role within Payment Integrity utilizes clinical background and relevant experience to lead the Clinical… more
- MyFlorida (Tallahassee, FL)
- 68900202 - OPS MEDICAL/HEALTH CARE PROGRAM ANALYST Date: Nov 6, 2024 The State Personnel System is an E-Verify employer. For more information click on our ... Care Administration Working Title: 68900202 - OPS MEDICAL/HEALTH CARE PROGRAM ANALYST Pay Plan: Temp Position...to fraud, abuse, and waste. The Bureau of Medicaid Program Integrity (MPI) does this specifically through… more
- AmeriHealth Caritas (Greenville, SC)
- ** Care Connector - Foster Care Program SC** Location: Greenville, SC Primary Job Function: Medical Management ID**: 37925 **Job Brief** This position is ... care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral… more
- LA Care Health Plan (Los Angeles, CA)
- …Degree Experience Required: At least 6 years of relevant Project Management, Program Management, Health Care Administration, Research or Clinical field work ... Enterprise Shared Services Program Manager II (ALD) Job Category: Administrative, HR,...$152,762.00 (Mid.) - $188,015.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created… more
- LA Care Health Plan (Los Angeles, CA)
- …product performance. Preferred: Knowledge of healthcare product types inclusive of managed care and insurance products. Additional duties include: Drives ... Required: Experience serving Medi-Cal population. Preferred: Understanding of Medi-Cal managed care model, eligibility requirements, benefits, enrollment… more
- University of Washington (Seattle, WA)
- …SOCIAL WORK** has an outstanding opportunity available for a **SOCIAL WORKER - INPATIENT CARE MANAGEMENT BED READINESS PROGRAM ** . **WORK SCHEDULE** * 40 hours ... and other health care staff who provide referrals to the Enhanced Care Management (ECM) program * Provide psychosocial support to patients and families… more
- Stanford Health Care (Menlo Park, CA)
- …Day - 08 Hour (United States of America) **This is a Stanford Health Care job.** Position Title: Program Manager, Design Records and Archive Department: ... and tracking/reporting to ensure project goals are met.** **Locations** **Stanford Health Care ** **What you will do** + Provides program leadership for… more
- AmeriHealth Caritas (Greenville, SC)
- ** Care Manager II Registered Nurse (BSN) - Foster Care Program -SC** Location: Greenville, SC Primary Job Function: Medical Management ID**: 37923 **Job ... to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and...these principles into action every day by acting with integrity and respect. We stand together to speak out… more
- AmeriHealth Caritas (Florence, SC)
- **REMOTE | Care Manager II Registered Nurse (BSN) - Foster Care Program -SC** Location: Florence, SC Primary Job Function: Medical Management ID**: 34390 ... to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and...these principles into action every day by acting with integrity and respect. We stand together to speak out… more
- LA Care Health Plan (Los Angeles, CA)
- …Preferred Bachelor's Degree Experience Required: At least 2 years of experience in Managed Care with specific experience in resolving member and provider ... the assets of the organization, acting with ethics and integrity , reporting noncompliance, adhering to company policy and procedures,...apply regulations. At least 5 years of experience in Managed Care working with Medicare, Medi-Cal and… more
- LA Care Health Plan (Los Angeles, CA)
- …The Account Manager III is responsible for the initial on-board training of new managed care contract provider partners, and for ensuring their provider accounts ... LAC; and providing in-service orientation meetings with providers. Responsible for monitoring managed care contracts for renewals and expirations. Acts the… more