- AmeriHealth Caritas (Columbia, SC)
- … care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral ... Your career starts now. We are looking for the next generation of health care leaders. At AmeriHealth Caritas, we are passionate about helping people get care ,… more
- AmeriHealth Caritas (Washington, DC)
- … care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral ... Your career starts now. We are looking for the next generation of health care leaders. At AmeriHealth Caritas, we are passionate about helping people get care ,… more
- Molina Healthcare (Columbus, OH)
- …investigative and law enforcement procedures with emphasis on fraud investigations. + Knowledge of Managed Care and the Medicaid and Medicare programs as well as ... **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit (SIU) Investigator is...on allegations of FWA and/or may determine appropriateness of care . The SIU Investigator is also responsible… more
- Molina Healthcare (Columbus, OH)
- …of CPT, ICD-9, HCPCS and DRG requirements. + Two years of managed care experience. **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION** : Active, unrestricted ... **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit (SIU) Investigator is...the medical necessity, level of services, and/or appropriateness of care in cases. The SIU Investigator is… more
- State of Michigan (MI)
- …Michigan's Medicaid Program, Mental Health Program, MIChild Program and Children's Special Health Care Services Program. These investigations may result ... Departmental Analyst 9-P11 - Healthcare Fraud Investigator - MDHHS OIG Integrity Division Print (https://www.governmentjobs.com/careers/michigan/jobs/newprint/4795098)… more
- Independent Health (Buffalo, NY)
- …using standard coding (HCPC, CPT, ICD-9, ICD-10) required. Experience in a managed care setting preferred. + Familiarity with insurance investigative processes, ... culture that fosters growth, innovation and collaboration. **Overview** The Fraud Investigator will develop, implement and administer the IH anti-fraud program,… more
- Morehouse School Of Medicine (Atlanta, GA)
- …of the health professional and scientific workforce; * Address primary health care through programs in education, research and service; With emphasis on people ... timelines, data management and analysis plans, partners with the Principal Investigator and provides guidance oversight of research assistant and peer… more
- MyFlorida (Miami, FL)
- …does this specifically through audits and investigations of healthcare providers, including managed care plans, suspected of engaging in fraudulent or abusive ... (http://www.dms.myflorida.com/workforce\_operations/human\_resource\_management/for\_job\_applicants/e\_verify) . Requisition No: 848837 Agency: Agency for Health Care Administration Working Title: 68063500 - INSPECTOR SPECIALIST Pay… more
- Mount Sinai Health System (New York, NY)
- …each payor within the patient population * Provides the clinical information requested by the managed care companies as part of the concurrent review in a timely ... fashion. * Provides clinical information requested by the managed care companies in accordance with contractual agreements. * Works collaboratively with… more
- University of Pennsylvania (Philadelphia, PA)
- …Temporary Employee - Non-Exempt Job Description Summary Provide specialized veterinary clinical care to all species housed in ULAR- managed facilities with rodent ... Under minimal supervision, triage and assess animal health, provide immediate care to emergency cases. Administer medications by oral, topical, and injectable… more
- University of Pennsylvania (Philadelphia, PA)
- …as immunoassays. The Research Specialist will design experiments with the Principal Investigator and will be expected to optimize and troubleshoot procedures as ... to ongoing clinical projects, ensuring CCTR lab's inventory and equipment are well- managed and fully functional. The specialist will assist the PIs with financial… more
- Mount Sinai Health System (New York, NY)
- …+ Oversee the cost model development and calculations at each facility + Work with managed care , finance and reimbursement staff on an ongoing basis to maintain ... the Health System in the evaluation and negotiations of managed care contracts and operations in conjunction...and enhances professional development to keep pace with health care trends. + Handles special projects assigned… more
- Mount Sinai Health System (New York, NY)
- …degree or greater in related field or equivalent education/experience Five years minimum of managed care experience in insurance claims or contracts Four to Five ... Medicare and Medicaid policies, regulations, legislation and other proposals, including managed care payer reimbursement policy changes. 8. Analyze impacts… more
- Mount Sinai Health System (New York, NY)
- …Projects and other collaborating departments to ensure grants are being properly managed . 6. Reviews and provides supplemental and amended information to extramural ... Projects for fund activation. 7. May implement, and supports special projects for the department or institute as needed....We share a common dedication to delivering outstanding patient care . When you join us, you become part of… more
- New York State Civil Service (Commack, NY)
- …for Title Rehabilitation Counselor 2 - EOA#: 2025-088 Occupational Category Health Care , Human/Social Services Salary Grade 19 Bargaining Unit PS&T - Professional, ... delivery of comprehensive day habilitation services provided by multi-disciplinary and direct care staff members at the program site and/or off-site locations. *… more
- Mount Sinai Health System (New York, NY)
- …of Neurology is strongly committed to caring for the whole patient and places special emphasis on providing patient-centered care , embracing the mission of the ... Sinai Health System, where you will provide high quality care for patients with a broad range of complex...not included in this role, as these are separately managed by our world-class Stroke Team. You will frequently… more
- Mount Sinai Health System (New York, NY)
- …of Neurology is strongly committed to caring for the whole patient and places special emphasis on providing patient-centered care , embracing the mission of the ... Neurology is recruiting for a Part-time/Per Diem Neuro-oncologist to care for patients admitted to the Mount Sinai Hospital.**...not included in this role, as these are separately managed by our world-class Neuro Hospitalist and Stroke Teams.… more
- Mount Sinai Health System (Queens, NY)
- …of Neurology is strongly committed to caring for the whole patient and places special emphasis on providing patient-centered care , embracing the mission of the ... Mount Sinai Health System. You will provide high quality care for patients with a broad range of basic...not included in this role, as these are separately managed by our world-class Stroke Team. You will frequently… more
- CSL Behring (King Of Prussia, PA)
- …+ Deliver approved educational programs to relevant healthcare audiences (eg HCPs, Managed Care Organizations, Specialty Pharmacies, etc.). + Provide areas of ... of medical-scientific knowledge and applies subject matter expertise and experience to special projects. This opportunity with our Immunology team will entail a… more
- CSL Behring (King Of Prussia, PA)
- …6) Deliver approved educational programs to relevant healthcare audiences (eg HCPs, Managed Care Organizations, Specialty Pharmacies, etc.). 7) Attend scientific ... clinical-scientific knowledge and applies subject matter expertise and experience to special projects. This opportunity with our Coagulation & Acquired Bleeding team… more