- CHRISTUS Health (Texarkana, TX)
- …the practice is efficient and cost effective for the services provided. ? Participates in managed care plans as directed and does so in an efficient and cost ... of that state Requirements: ? Develops a plan of care for each patient, including a complete medical history,...Chief Medical Officer. ? Refers those cases that require specialist services, but will maintain responsibility for assuring that… more
- Jennie Stuart Medical Center, Inc. (Hopkinsville, KY)
- Managed Care Specialist Job Summary Handles credentialing and enrollment processes for healthcare providers and facilities. This role is critical to the ... of Western Kentucky Healthcare System (WKHS) and the Jennie Stuart Health Managed Care Department, supporting accurate provider setup and alignment with… more
- LA Care Health Plan (Los Angeles, CA)
- Credentialing Specialist II Job Category: Provider Relations Department: Provider Data Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... net required to achieve that purpose. Job Summary The Credentialing Specialist II is responsible for managing...At least 1 year of experience in a healthcare/ managed care environment. Skills Required: Ability to… more
- The County of Los Angeles (Los Angeles, CA)
- CREDENTIALING SPECIALIST Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/3476028) Apply CREDENTIALING SPECIALIST Salary $65,911.68 ... for periodic audits by Consolidated Accreditation and Licensure Survey and Office of Managed Care as requested; conducts internal reviews; and completes required… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …am to 5 pm **Work Location:** El Paso **Preferred Qualifications:** + Three years of Credentialing experience in a managed care plan, medical staff services ... **43331BR** **Extended Job Title:** Medical Staff Credentialing Specialist **Org Level 1:** Texas...education and experience is required + Three years of Credentialing experience in a managed care… more
- Union Hospital Health Group (Terre Haute, IN)
- …Credentialing Specialist Details Essential Job Duties: + Credentialing /re- credentialing applications for managed care organizations and hospitals ... You belong at Union! The Payor Credentialing Specialist plays a key role...with revenue cycle duties and analysis + Performing other managed care tasks as assigned Education, Training… more
- AccentCare, Inc. (Dallas, TX)
- Overview Managed Care Contract Specialist Location: Dallas Corporate Office Position: Managed Care Contract Specialist Position Type: Full-Time ... this role. Find Your Passion and Purpose as a Managed Care Contract Specialist What...+ Maintain monthly MC logs that summarize negotiation and credentialing activity. Maintain MC monthly logs for moves and… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …diploma or equivalent and one year of credentialing experience in an acute care hospital, managed care organization and/or credentialing verification ... JOB DESCRIPTION: + Under general supervision, coordinates activities related to credentialing of Medical Staff and Allied Health professionals. Serves as a… more
- Trinity Health (Livonia, MI)
- …leadership. Fields telephone calls and monitors shared email inbox regarding managed care products, application requests, credentialing /recredentialing ... MSOW database and ensures mailing addresses, telephone numbers, participation in various managed care organizations, and other key demographics are up to… more
- East Boston Neighborhood Health Center (Revere, MA)
- …care preferred. EXPERIENCE: One to three year's experience working in a Medical Staff Office, Credentialing or Managed Care in a hospital, managed ... of our patients and communities. Whether you're a nurse or physician providing direct care , a manager leading dedicated teams, or part of the essential support staff… more
- Houston Methodist (Houston, TX)
- …the designated area(s) of responsibility or populations served. The Pharmacy Clinical Specialist position supports the delivery of pharmacy managed protocols, ... At Houston Methodist, the Pharmacy Clinical Specialist position is responsible for performing advanced clinical pharmacy duties enabling the delivery of optimal… more
- Houston Methodist (The Woodlands, TX)
- …the designated area(s) of responsibility or populations served. The Pharmacy Clinical Specialist position supports the delivery of pharmacy managed protocols, ... At Houston Methodist, the Pharmacy Clinical Specialist position is responsible for performing advanced clinical pharmacy duties enabling the delivery of optimal… more
- UPMC (Pittsburgh, PA)
- …complex situations accurately and in a timely manner. + General knowledge of managed care functions and management techniques preferred. + Computer Skills with ... Care Behavioral Health is hiring a full-time Contract Specialist III. This role will work in a hybrid...systems. + Review and approve specific inquiries related to credentialing and/or provider data maintenance. + Participate in projects… more
- Veterans Affairs, Veterans Health Administration (Providence, RI)
- …position is Full Time at 40 hours per week and functions within Patient Aligned Care Teams (PACT). The Clinical Pharmacy Specialist serves as a provider with ... after complete review of the EDRP application. Responsibilities This Clinical Pharmacy Specialist (Women's Health) position is in the Pharmacy Department at the VA… more
- Dignity Health (Bakersfield, CA)
- …, provider database maintenance and reporting, provider contracting and/or network development in a health care or managed care setting - HS diploma or GED - ... is maintained in each region. The Provider Data Management Specialist is an employee of Dignity Health Management Service....pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to… more
- Generations Family Health Center (Willimantic, CT)
- …oral health or behavioral health setting, and knowledge of insurance plans and managed care plans. Coding certificate or training preferred. Knowledge of medical ... Type Full Time Job Shift Day Education Level High School Category Health Care Description Billing Specialist Full-time, 40 hours/week Generations Family Health… more
- CareFirst (Baltimore, MD)
- …years' experience in risk adjustment coding, ambulatory coding and/or CRC coding experience in managed care ; state or federal health care programs; or health ... claims submissions. Utilizes extensive coding knowledge, combined with medical policy, credentialing , and contracting rules knowledge to help build the effective… more
- BronxCare Health System (Bronx, NY)
- …system and operational changes regarding insurance, eligibility and reporting, ie Managed Care Payers, Medicare. Keeps front-end administrators up-to-date with ... and performance reviews for various clinic locations. - Identifies that provider credentialing information is consistent in each system along the billing continuum… more
- Atlantic Health System (Morristown, NJ)
- …+ Support and evaluate delegated credentialing contracts and relationships with managed care organizations and insurers, if requested. + Lead change ... in Medical Services Management) required. + CPCS (Certified Provider Credentialing Specialist ) preferred. Key Competencies: + Executive...one of our facilities, will receive the highest quality care delivered at the right time, at the right… more
- Commonwealth Care Alliance (Boston, MA)
- …Strong claims experience + Mentoring subject matter expert of the team + Managed Care experience (preferably Medicare/Medicaid) + Experience in health plan ... + **Operational Excellence:** + Collaborate with cross-functional teams (eg, Claims, Credentialing , Clinical Care Management, Member Services, Provider Services,… more
