- MaineGeneral Health (Waterville, ME)
- …seeking a finance professional to join our experienced team as the Director of Reimbursement and Managed Care who will oversee all aspects of ... reimbursement , managed care contracts, and payer enrollment. The successful candidate will have a deep understanding of healthcare finance, regulatory… more
- UCLA Health (Los Angeles, CA)
- Description The Assistant Director , Managed Care Operations is responsible for the collaborative development, implementation and ongoing operations of ... contract performance. In this role, you will assist the Director , Managed Care Operations in...delegated health care model, capitation and other managed care IPA and provider reimbursement… more
- AdventHealth (Maitland, FL)
- …degree with not less than 10 years of experience in managed care , patient financial services, healthcare reimbursement , accounting and contract management. . ... This position will be responsible for execution of the managed care payor dispute resolution processes for...dispute resolution processes. The position reports to the Executive Director of Reimbursement and Compliance. Experience in… more
- Guidehouse (Mclean, VA)
- …and partner with existing / new clients to increase the scope of Guidehouse Managed Services' work. + Monitor and oversee a number of engagements to ensure timely ... Basic Life & Supplemental Life + Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts + Short-Term & Long-Term Disability + Tuition … more
- The New Jewish Home (Bronx, NY)
- …skilled nursing home billing is required + Must Understand Medicare, Managed Care , Medicaid (NY) billing and reimbursement + Prior experience working with ... in Waters Place, Bronx is seeking a full time Managed Care Billing Specialist to join our...issues affecting AR. + Work closely with Revenue Cycle Director and Director and resolve issues as… more
- Beth Israel Lahey Health (Boston, MA)
- … care or specialty physicians, their patients and practices to coordinate and process managed care referrals and / or authorizations for patient care ... services, complying with BIDCO's and BIDMC's contractual rules for multiple managed care insurance payers. **Job Description:** **Essential Responsibilities:**… more
- Abbott House (Bronx, NY)
- Job Summary: The Medicaid Managed Care Liaison is the primary contact person for the Medicaid Managed Care Plans (MMCP). MMC Liaison must have ... requirements + The unique complex needs of the foster care population + Medicaid Managed Care...+ Perform other secretarial duties as requested by Medical Director . + Any other related duties as required Educational… more
- Baystate Health (Springfield, MA)
- **Summary:** Under the direction of the Director of Managed Care , the Managed Care Contract Manager is responsible for the key components of the ... higher quality or less costly care . Primary responsibilities of the Managed Care Contract Manager include performing contract analysis, developing payer… more
- Stryker (MD)
- … care reform risk, shift from payer to provider, Medicare and Medicaid Managed Care . Design. Develop and deliver training programs that explain the risks ... health care reform risk, shift from payor to provider, Medicare and Medicaid Managed Care . + Experience in contributing to growth through securing favorable … more
- LA Care Health Plan (Los Angeles, CA)
- Senior Director , Care Management Job Category: Clinical Department: Care Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ... required to achieve that purpose. Job Summary The Senior Director , Care Management (CM) is responsible for...Medicare and Medicaid Service (CMS), California Department of Health Care Services (DHCS)], California Department of Managed … more
- Nuvance Health (Norwalk, CT)
- …appeals, at the first level of appeal as appropriate, in an effort to maximize reimbursement . Reviews and edits Managed Care Contract Language relating to ... goals in accordance with all State and Federal Guidelines. Responsibilities: 1. Director Care Coordination- Major Responsibilities Criteria A: Provides direct… more
- Athena Health Care Systems (East Providence, RI)
- …We are hiring a Director of Rehabilitation (Therapy) to join our dynamic care team at Orchard View Manor in East Providence! Working with our team and residents ... Director of Therapy Full-Time Orchard View Manor -...+ Strong organizational and analytical skills. About Athena Health Care Systems: Orchard View Manor is managed … more
- Providence (Portland, OR)
- …recommendations for budgetary increases/reductions to manage changing climate of mental health care directly to the Senior Director of behavioral health. ... Director of Behavioral Health to ensure cost-effective, superlative care -delivery across multiple clinical services/programs. Develops and oversees quality-assurance… more
- LA Care Health Plan (Los Angeles, CA)
- …metrics management. Preferred: Experience in Commercial Product Dev and Management within managed care health plan/payer. Experience with individual / family and ... Senior Director , Commercial and Group Product Management Job Category:...and inspire others to follow. Skills Required: Knowledge of managed care products, benefit intent, services and… more
- Diversicare Healthcare Services & Diversicare Ther (Arab, AL)
- … documentation specialist, ensuring accurate and timely completion of Medicare and Managed Care regulatory guidelines. + Review Additional Documentation Requests ... **Overview** **Lead the Way as Director of Care Coordination at Diversicare!**...package, including medical/dental/vision coverage, an excellent 401k plan, tuition reimbursement , vacation, holiday, and sick time, long and short-term… more
- LA Care Health Plan (Los Angeles, CA)
- …implementing compliance programs, policies and practices; and/or managing health plan/ managed care business operations. Demonstrate progressive improvement in ... Department, leading compliance efforts across all functions across LA Care . The Senior Director manages the following...benefits including + Paid Time Off (PTO) + Tuition Reimbursement + Retirement Plans + Medical, Dental and Vision… more
- Alameda Health System (Oakland, CA)
- …Title 22 and other regulatory agencies and overall hospital policies; integrates managed care contract criteria into overall Case Management functions. + ... Director , Inpatient System Care Management +...CM with completion of financial analyses including cost of care to reimbursement , denials management, and non-reimbursed… more
- Kelsey-Seybold Clinic (Houston, TX)
- …including Ambulatory Services, Information Systems, Finance, Purchasing, Human Resources, Managed Care , Marketing, Medical Records, Quality Improvement, Risk ... **Responsibilities** The Regional Director , Medical Imaging reports to Vice President of...years project management experience Strong working knowledge of health care /clinical operations 5 years' experience in regulatory guidelines and… more
- VIP Care (Tampa, FL)
- …+ 3 or more years of clinical experience + 3 or more years of managed care experience + Experience in Utilization Management and Physician Improvement Programs + ... Summary/Objective: The Senior Medical Director is responsible for leading efforts to develop...Health and At Home programs and meet with Primary Care Providers to develop action plans to help improve… more
- UCLA Health (Los Angeles, CA)
- …- Experience working in and leading clinical teams in Managed Care , Medicare Advantage, or other value-based reimbursement models. - Proven experience ... Description The Medical Director for Senior Care (MD SC) at UCLA Health will be responsible for the establishment and oversight of specialized Senior Care … more