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Managed Care Modeler Jobs

Managed Care Analyst Jobs
By Valley Health System of Ridgewood, NJ At , Ridgewood

Area of Talent: Professional Administration

Managed Care Manager, Contracting
By UofL Health At , Louisville, 40202
5 years experience with Contracting and Providers/Managed Care Payors
Implement and administer managed care and value based contracting strategies
Renegotiate Payor agreements with managed care companies, including language assessment, rate analysis, and product line impacts
Analyze managed care data for fee analyses
Complies with HIPAA privacy and security requirements to maintain confidentiality at all times
Competitive Pay & Benefits Options
Managed Care Analyst- Remote
By Premier Health At , Dayton, 45459
Other experience requirements: 1-2 years advanced Financial Analysis
PREMIER SYSTEM SUPPORT REMOTE POSITION / FULL TIME / 8A-4:30P/ 80 HOURS PER PAY
Minimum Level of Education Required: Bachelor's degree
Type of degree: Accounting, Finance, Healthcare Administration or related field
Minimum Level of Experience Required: 1 - 3 years of job-related experience
Strong statistical and analytical skills – Proficient in Excel
Managed Care Authorization Specialist
By AgeSpan At Lawrence, MA, United States
Encouragement of your development through opportunities to get involved, use your voice, and gain new knowledge and skills.
Support Management with updates and maintenance of forms and document, both digital and paper.
Data entry as requested or as needed in A&D or SCO databases including adding new members and closing disenrolled members
Attend any team, Managed Care Department and All Staff meetings and complete agency required trainings.
A refreshing culture that is supportive, collaborative, and encouraging of diverse perspectives and backgrounds.
A focus on innovation with a team recognized for developing and implementing innovative programs and novel solutions.
Managed Care Information Analyst
By Dept of Med Assistance Svcs At , Richmond $84,000 - $84,962 a year

Title: Managed Care Information Analyst State Role Title: Information Technology Specialist II Hiring Range: $84,000 - $84,962 Pay Band: 5 Agency: Dept of Med Assistance ...

Manager Managed Care Jobs
By Roper St. Francis Healthcare At Ladson, SC, United States

Job Summary Responsible for managed care initiatives & performance, including contracting, reporting, and operations, related to hospitals, physicians (employed and contracted), Home Health, ...

Managed Care Contracting Manager California- Remote
By Ernest Health At United States
· Demonstrates general computer skills including: data entry, word processing, email, and record management.
· Effective organizational and time management skills.
· Bachelor’s Degree preferred OR any equivalent combination of education and experience.
· Knowledge of managed care procedures and laws required.
· Knowledge of regulatory standards and compliance requirements.
Tuition and continuing education reimbursement
Home Care Managed Care Coordinator
By Vanderbilt University Medical Center At , Nashville, 37232
Authorization Evaluation (Intermediate): Possesses sufficient knowledge, training, and experience to role model and coach less experienced peers.
Confer with other MCC's, brainstorm on any new payer process changes, and update Payer Auth Requirement document
The responsibilities listed are a general overview of the position and additional duties may be assigned.
Obtain Start of Care (SOC) authorization.
Obtain Add-on prior authorization, obtain prior authorization for Resumption of Care (ROC), obtain concurrent authorization.
Review written off no authorization (wona) requests from billing team for possible.
Contract Specialist, Managed Care
By UF Health Shands Hospital At , Gainesville, 32608 $31.78 - $43.96 an hour
Minimum Education and Experience Requirements:
Advanced managed care experience may substitute for the degree on a year-by-year basis.
Three to five years of managed care experience preferred.
Master's degree may substitute for the required experience on a year-by-year basis.
Director-Managed Care Jobs
By Mercy At , Chesterfield, 63017
Required Education: Bachelor's Degree in health care or business administration
Preferred Education: Master's Degree in Business or Health Administration
We're bringing to life a healing ministry through compassionate care.
What Makes You a Good Match for Mercy?
Director - Managed Care
By NewYork-Presbyterian Hospital At , Manhattan, 10065 $154,000 - $208,000 a year
Oversee the loading of Managed Care contracts into hospital’s billing and cost accounting systems.
Execute and manage one-time deal agreements and processes with non-contracted payers.
Five to seven years of previous work-related experience.
Experience the Pride of a Mission-Driven Career
Submit and oversee the hospital’s applications for insurance carriers’ centers of excellence.
Act as subject matter expert for transplant and psychiatric contracting matters.
Manager-Managed Care Jobs
By Mercy At , Chesterfield, 63017
Experience: Minimum of 3-5 years of managed care experience is a requirement, contracting experience is preferred
Required Education: Bachelor's Degree in health care or business administration
We're bringing to life a healing ministry through compassionate care.
What Makes You a Good Match for Mercy?
Managed Care Resource Jobs
By Quorum Services At , Tempe, 85282, Az $80,000 - $120,000 a year

Purpose of Your Position: To establish, implement, and evaluate the strategic plan(s) and managed care contracting and partnership opportunities that will ensure each logical operation to build ...

Compliance Specialist - Mso - Managed Care Operations
By Rady Children's Hospital-San Diego At , Remote $30.96 - $42.57 an hour
5 years of Managed Care experience
Self-motivated with the ability to independently create, plan, organize and coordinate related activities to the position
Comfortable interacting with executive level positions both internally and externally
Manager, Managed Care Ancillary
By Tampa General Hospital At , Tampa, 33606, Fl $79,268 a year

Bachelor’s Degree in Business Administration, Hospital Administration or related field

Highly proficient in using multiple computer applications for analyzing data, communicating, and producing reports.

Managed Care Operations Manager
By UMass Memorial Health At , Worcester, 01605, Ma

Provides effective direction, guidance, and leadership in conducting monthly claims meetings and fosters effective teamwork in problem resolution.

Participates in performance improvement initiatives and demonstrates the use of quality improvement in daily operations.

Vice President Of Managed Care
By SHR Talent At , Brentwood, Tn $180,000 a year
Extensive knowledge of managed care operations, reimbursement models, and healthcare provisions
Develop and execute managed care strategies to enhance revenue and ensure financial viability
Analyze reimbursement rates and managed care contracts, identifying opportunities for improvement
Collaborate with cross-functional teams to implement effective managed care initiatives
Monitor and assess the financial performance of managed care contracts, ensuring compliance with provisions
Provide strategic guidance on managed care matters, supporting executive decision-making
Auditor, Medicaid Managed Care (Full-Time, Remote)
By Integrity Management Services, Inc. At Alexandria, VA, United States
Typically 2+ years of related experience in finance, accounting, or auditing
Medicaid managed care work experience
Used Unified Case Management (UCM) and One PI Business Objects
Knowledge of the healthcare industry and medical coding concepts (CPT, ICD-9 / 10, DRGs) and/or experience analyzing health care claims data
Bachelor’s degree in finance, accounting, or related field preferred
Intermediate understanding of Medicaid managed care
Managed Care Member/Provider Specialist
By State of Iowa Talent Gateway At , Des Moines, 50319, Ia $59,322 - $92,040 a year
Manage within a capitated rate.
Modified CMS service requirements, State regulations and administrative rules.
Prepare monthly, quarterly, and annual MCO member and provider reports to meet state and federal requirements.
Review and provide feedback to Iowa Medicaid policies impacting MCO contract requirements and performance.
modified CMS service requirements, State regulations and administrative rules.
Provide member and provider service.
Senior Operations Executive - Managed Care/ Medicare Advantage Expert
By Chicago Pacific Founders At United States

Based in Chicago and San Francisco, Chicago Pacific Founders ("CPF") is a leading strategic private equity firm focused on building and scaling companies within the healthcare services sector. This ...