- HCA Healthcare (Nashville, TN)
- …**Introduction** Do you want to join an organization that invests in you as a Case Management Managed Care Consultant? At HCA Healthcare, you ... and you have the opportunity to make a difference. We are looking for a dedicated Case Management Managed Care Consultant like you to be a part of our… more
- Humana (Nashville, TN)
- …Rico. + Bachelor's Degree. + Minimum 3 years of experience working in a clinic, hospital case management , managed care / healthcare setting - working with ... duty family members; assistance with regional transfers and ensuring the receiving Managed Care Support Contractor receives the appropriate paperwork; processes… more
- Elevance Health (Nashville, TN)
- …care hospital setting, ie ER, ICU, Critical Care preferred. + Prior "telephonic" Case Management experience with a Managed Care Company preferred ... Case Manager II** is responsible for performing care management within the scope of licensure...respond to emails/instant messages in a timely fashion. + Managed Care (Home Heath, Insurance, Inpatient) experience.… more
- Humana (Nashville, TN)
- …system-related issues **Preferred Qualifications** + BSN or MSN degree + Case Management experience + Managed care experience + Certified Case ... helping adults remain independent in their homes. Our nurses are called Care Managers, because our case management services are centered on the person rather… more
- Humana (Nashville, TN)
- …and use of business metrics. + Experience working with Case managers or Care managers on complex case management , including familiarity with social ... of decisions to internal associates, and possible participation in care management . May occasionally participate in discussions...in teams focusing on quality management , utilization management , case management , discharge planning… more
- Highmark Health (Nashville, TN)
- …in Medical Management in a Health Insurance Plan; strong knowledge of managed care industry **LICENSES AND CERTIFICATION** **Required** + Medical Doctor or ... need. **Preferred** + None **SKILLS** + Critical Thinking + Case Management + Customer Service + Oral...Skills + General Computer Skills + Clinical Software + Managed Care **Language (Other than English)** None… more
- Humana (Nashville, TN)
- …and Excel **Preferred Qualifications** + Bachelor's degree - BSN + Experience with case management , discharge planning, and patient education for adult acute ... care + Managed care experience + Previous Medicare/Medicaid experience + Bilingual English/Spanish **Additional Information** + Associate will be expected to… more
- Humana (Nashville, TN)
- …and use of business metrics. + Experience working with Case managers or Care managers on complex case management , including familiarity with social ... of decisions to internal associates, and possible participation in care management . The clinical scenarios predominantly arise...in teams focusing on quality management , utilization management , case management , discharge planning… more
- Humana (Nashville, TN)
- …Substance Use Disorder Population. + Experience working with Case managers or Care managers on complex case management , including familiarity with social ... of decisions to internal associates, and possible participation in care management . The clinical scenarios arise from...in teams focusing on quality management , utilization management , case management , discharge planning… more
- Humana (Nashville, TN)
- …prior experience participating in teams focusing on quality management , utilization management , case management , discharge planning and/or home health or ... services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed … more
- Valor Health (Columbia, TN)
- …solution focused counseling, education and referral for resources and benefits, and case management . Develops program content and organizes & leads activities ... continuity of care through the PCMM (Primary Care Management Module). + Evaluates patients records...patients utilizing rules set forth by the VA for co- managed care . + Conducts individual, group, and… more
- HCA Healthcare (Nashville, TN)
- … objectives. This role requires strong analytical leadership, a deep understanding of managed care pricing strategies, and close collaboration across PCA teams ... enterprise-including hospital, government, and regional teams-on all contracting activities with managed care organizations (MCOs) and other payers. + Develop… more
- Humana (Nashville, TN)
- …management , or similar activities **Preferred Qualifications:** + Knowledge of the managed care industry, Integrated Delivery Systems, health insurance, or ... where the analysis of situations or data requires a case by case consideration of the Medicare...+ Utilization management experience in a medical management review organization such as Medicare Advantage, managed… more
- Green Hills Center for Rehabilitation and Healing (Nashville, TN)
- …an understanding of MDS requirements related to varied payers including Medicare, Managed Care and Medicaid + Ensures timely electronic submission of ... regulations and company policy and procedures. Acts as in-house case manager by considering all aspects of the residents...that appropriate follow-up action is taken + Facilitates the Care Management Process engaging the resident, IDT… more
- Ford Motor Company (Nashville, TN)
- …Mesh, Anthos, Pub/Sub, Dataflow, Cloud Scheduler, Bigtable, AlloyDB and other managed services. + Possess experience with Google Cloud infrastructure provisioning ... including VPC, Subnet, Gateway, Security groups, managed services, Kubernetes Cluster etc. + Possess expertise with automating Infrastructure as Code using… more
- HCA Healthcare (Nashville, TN)
- …cycle operations experience strongly preferred. + Minimum 5 years health care management /leadership experience required. + Experience leading large organizations ... clinical documentation improvement, practice coding processes, and division relationship management as applicable. The RCOM assists the Regional Coding Operations… more
- Western Digital (Nashville, TN)
- …emerging storage business models. The ideal candidate will bring a management consulting background with experience advising technology companies on platform ... models). + Assess market opportunities in Software-Defined Storage (SDS), storage management platforms, data orchestration, and tiered storage solutions. + Evaluate… more
- HCA Healthcare (Nashville, TN)
- …practices. + Maintains/obtains professional competence and knowledge of healthcare economics, managed care /reimbursement issues in the industry. + Attends ... auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. + Free counseling… more
- HCA Healthcare (Nashville, TN)
- …private payer regulations and processes. You will possess a thorough understanding of managed - care concepts and length-of-stay management relating to patient ... in this role: + You will work collaboratively with RN case managers, acute care nurses, physicians, insurance companies, and other staff members to proactively… more
- HCA Healthcare (Nashville, TN)
- …private payer regulations and processes. You will possess a thorough understanding of managed - care concepts and length-of-stay management relating to patient ... in this role: + You will work collaboratively with RN case managers, acute care nurses, physicians, insurance companies, and other staff members to proactively… more