. About the Opportunity The Managed Care Consultant supports the Skilled Nursing Facility leaders in managed care contracting... Consultant will provide guidance regarding development of managed care relationships and rate negotiation, ensuring timeliness...
, and psychosocial well-being of those being served. No license is required. Managed care experience preferred. Ability to interact... Partners (SCP). The Care Manager Associate (CMA) position will be part of the UPMC Health Plan's Community Services Community...
to employability programmes and specialist support, we do work that matters with people who care. This role is a fixed-term contract... resource systems and processes to advise personnel on policy related matters, right to work, vetting, and payroll...
and managed care is required. The ability to use expert clinical practice, leadership skills, and critical thinking skills... overall team performance and continuity in conjunction with the Sr. Director of Risk Management Serves as a resource to team...
delivered with a service excellent attitude. Ability and willingness to work in a managed care environment. Excellent ability... in delivery of patient care for assessment and disposition/referral planning. Efficiently take a sizable volume of calls...
, and strong understanding of managed care regulations Experience with various computer software programs Preferred Associate's degree... leadership team in achievement of organizational goals and initiatives. Serves as an advocate, resource, and designated leader...
and Medicare managed care is highly preferred for this position, Responsibilities: Develop and maintain collaborative... Health Plan and the participating providers of the UPMC Health Plan Network. The Physician Educator is the primary resource...
and make independent decisions. Know insurance pre-certification/pre-authorization, Managed Care, Medicare/Medicaid... as a resource person for technical and/or operational questions as a liaison with clinical and non-clinical departments, ensuring...
-authorization, Managed Care, Medicare/Medicaid and Commercial insurance plans. Prior working experience on personal computers... event of problems and/or staffing concerns. Serve as a resource person for technical and/or operational questions...
experience, and a strong understanding of managed care regulations are preferred. Experience with personal computer-based.... Central Resource for all ADT registration and problem resolution during evenings, weekends and holidays. Confirms insurance...
required. Medical terminology, third party health care coverage experience and strong understanding of managed care regulations... principles of Your Care. Our Commitment and abide by all UPMC departmental policies, procedures and goals in the process...
of Mental Health (DPW), the PA Department of Education, and managed care organizations (Community Care Behavioral Health..., state, and managed care organizations Manage/Oversee of Electronic Health Record System: Performs duty of System...
with Azurity senior leadership to assess strategy deployment performance and ensure teams have clarity on resource needs..., managed markets, or related field. Strong understanding of U.S. payer, PBM, and specialty pharmacy landscape. Proven track...
for you! What’s In It for You: Flexible schedule, managed by you on a mobile app Vetted families Variety of work environments - including... in families homes, childcare centers, church nurseries, on-site event care, and more! Opportunities for training and professional...
/managed care with specific knowledge of quality monitoring, compliance and/or regulatory processes 2 years experience... or more years’ experience working in the health care/health insurance industry Quality Management System certification Knowledge...
in internal complex case reviews utilizing information from Client Information System (CIS), Managed Care Organizations (MCOs... in planning activities related to Waiver Capacity Management. o Understands and utilizes Trauma Informed Care principles...