- Astor Services (Rhinebeck, NY)
- Managed Care Liaison and Credentialing Specialist Supervisor Rhinebeck, NY (http://maps.google.com/maps?q=6339+Mill+Streeet+Rhinebeck+NY+USA+12572) Job ... Type Full-time Description The Managed Care Liaison and Credentialing Specialist Supervisor is responsible for developing relationships with managed … more
- Childrens Hospital of The King's Daughters (Chesapeake, VA)
- …are informed of payer policy changes and their operational impacts. Act as a liaison between managed care organizations and internal departments to ensure ... + GENERAL SUMMARY + The Leader, Managed Care Contracting, is responsible for...revalidation efforts to maintain compliance with managed care organizations, Medicaid, and other payer credentialing … more
- RWJBarnabas Health (Newark, NJ)
- …Essential Functions: + Work closely with New Jersey Medical School Managed Care Department + Process and maintain credentialing and re- credentialing ... liaison to providers, operations regulators and leadership on credentialing -related matters regarding Medicaid and Medicare Applications + Reviews … more
- OLV Human Services (Lackawanna, NY)
- …OLV Human Services staff members to carry out the responsibilities within our Foster Care contracts and Medicaid Managed Care Plans assisting with any ... Care Coordinators of the contracted MMCPs (Medicaid Managed Care Plans) in our area. In...**Essential Job Duties:** 1. Coordinate with the MMCP's foster care liaison /coordinator 2. Will attend all meetings… more
- AbbVie (North Chicago, IL)
- …& Access department who uses clinical expertise and experience/ knowledge of managed care , health policy, and pharmacoeconomics to support AbbVie's scientific ... care entities, including but not limited to, managed care organizations (MCOs), specialty pharmacy providers...essential requirement of the position is to meet health care industry representative (HCIR) credentialing requirements to… more
- Eastern Connecticut Health Network (Manchester, CT)
- …Connecticut State licensure inspection surveys. + Responds to inquiries from other health care institutions, managed care organizations and ECHN departments ... activities of the Medical Staff Office, and the activities of the ECHN Credentialing Program, in compliance with state and federal regulations and Joint Commission… 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
- Ventura County (Ventura, CA)
- …the current principles and techniques of diagnosis and treatment. + Experience with managed care . + Experience and current knowledge of Quality Assurance, ... Board Certified Doctor of Medicine and includes the following: + Experience with managed care + Experience and current knowledge of Quality Assurance,… more
- Penn Medicine (Philadelphia, PA)
- …**Education or Equivalent Experience:** + HS Diploma/GED. (Required) + 6+ years of credentialing experience in a managed care , hospital, or related ... CMS. The Medical Staff Office Specialist serves as a liaison between hospital administration/department administration and the Office of...(Required) Or + Bachelor's degree and 4+ years of credentialing experience in a managed care… more
- LA Care Health Plan (Los Angeles, CA)
- …The Account Manager II is responsible for the initial on-board training of new managed care contract provider partners, and for ensuring their provider accounts ... LAC; and provide in-service orientation meetings with providers. Responsible for monitoring managed care contracts for renewals and expirations. Act as the… more
- Northwell Health (New York, NY)
- …inquiries from participating physicians, network staff, hospital staff, and managed care companies. + Resolves issues related to credentialing , managed ... Facilitates re- credentialing requests and coordinates site visits related to managed care contracts. + Prepares and reviews physician membership… more
- HCA Healthcare (El Paso, TX)
- …+ You will provide medical consultation on contracting, pricing, and analysis of managed care issues. Offers clinical support for appeals and denials process, ... regarding delegated utilization management and disease management operations under managed care contracts. You will meet all regulatory/contractual/accreditation… more
- Mount Sinai Health System (New York, NY)
- …identified and resolved. 6. Oversee and supports the national payer contracts, acting as managed care liaison for internal and external constituents in all ... Central Billing Office (CBO) and Change Departments with key aspects of Managed Care contracting support including communication, fee schedule access,… more
- BrightSpring Health Services (Oklahoma City, OK)
- …five (5) years of healthcare related experience, preferably with contracting and credentialing responsibilities ( managed care , government, PBM); home ... Payer Implementation functions as well as PBM contracting and Managed Care contracting. This is a highly...support current and expansion markets + Acts as payer liaison focused on addressing Home Infusion Therapy (HIT) and… more
- Atlantic Health System (Pompton Plains, NJ)
- …2 years preferred, Acute Care hospital experience 2 years preferred, Managed Care experience, Electronic Medical Record, (EMR) experience preferred. + ... shifts at the Chilton Medical Center. Responsible for supervising and providing care to the patients by matching the patient's needs with appropriate services.… more
- Mount Sinai Health System (NJ)
- …practices economical and effective healthcare + Completes in a timely manner all managed care applications, credentialing , and re- credentialing requests ... in accordance with Institutional policies + Act as a liaison between VMG physicians and VMG and Hospital business...compliance activities with the goal of optimizing and improving managed care reimbursement through efficient clinical delivery… more
- Mount Sinai Health System (New York, NY)
- …payor within the patient population; 2. Provides the clinical information requested by the managed care companies as part of the concurrent review in a timely ... fashion. 3. Provides clinical information requested by the managed care companies in accordance with contractual...Patient Review Instrument (PRI) for patients requiring Residential Health Care Facility placement. 4. Liaison with financial… more
- Mount Sinai Health System (New York, NY)
- …payor within the patient population; b. Provides the clinical information requested by the managed care companies as part of the concurrent review in a timely ... fashion. c. Provides clinical information requested by the managed care companies in accordance with contractual...Patient Review Instrument (PRI) for patients requiring Residential Health Care Facility placement. d. Liaison with financial… more
- Baylor Scott & White Health (Frisco, TX)
- …skills. 8. Solid clinician skills with understanding of risk management, managed care contracting, national benchmarking, and related quality metrics. ... Scott & White Medical Center - Centennial, which may include patient care operations, patient quality, patient safety, infection control, risk management, joint… more
- ERP International (Camp Pendleton, CA)
- …appropriate community agencies and organizations, the TRICARE Lead Agent office, and the Managed Care Support Contractor. + Maintain adherence to JCAHO, URAC, ... **Camp Pendleton, CA.** **Be the Best!** Join our team of exceptional health care professionals across the nation. Come discover the immense pride and job… more