, utilization review, managed care organization quality review, and quality assurance for programs serving individuals...Medical Review RN / Nurse Specialist II Work from Home within the Continental United States @Orchard LLC...
Immediate need for a talented Atlassian Organization & Multiple Site Administrator (Engineering-Focused). This is a 06...+months contract opportunity with long-term potential and is located in U.S(Remote). Please review the...
state of Wisconsin. FTCH has a large, academic medical center in partnership with the Medical College of Wisconsin... in an organization that is transforming healthcare in Wisconsin. Job Summary: Reporting to the Vice President, General Counsel...
The Senior Managed Care Analyst will collect and analyze data on costs, charges and utilization to support negotiations... with managed care companies. Will develop and implement appropriate tools to expedite effective evaluation and monitoring...
Anticipated End Date: 2025-11-21 Position Title: Managed Care Pharmacy Resident Job Description: Managed Care... of new technologies and a strong, clinical-first lens, to deliver member-centered, lasting pharmacy care. The Managed Care...
pricing and contracting customer strategies for product launches and educating the organization on managed markets issues... to build strategic relationships with national managed care accounts and their affiliates, regional accounts, and state...
of National pharmacy and medical benefit payer contracts, including Commercial, Medicare and Managed Medicaid Assess contract... medicines, and the proud producer of many of the products on the World Health Organization's Essential Medicines List...
to the team: Coordinates, and monitors the review and analysis of practitioner applications and accompanying documents.... Assists with managed care delegated credentialing audits; conducts internal file audits. Utilizes the MSOW/Apogee...
is dedicated to managed care contracting – you will learn to read payer contracts (commercial and government), model reimbursement... revenue). Work with Managed Care/Finance, Revenue Integrity/CDM, PFS, and IT/Data teams to align interpretation, data sources...
well-being of our nonprofit clients and the communities they serve. As an AI-first organization, we keep our eyes tuned... in office. Role Overview As a Project Manager within fusionSpan's Managed Services team, you will be a key leader...
well-being of our nonprofit clients and the communities they serve. As an AI-first organization, we keep our eyes tuned... in office. Role Overview As a Project Manager within fusionSpan's Managed Services team, you will be a key leader...
Job Location: Maitland, FL The role you will contribute: This position is responsible for contract review and interpretation... adjudication. Provides guidance and direction to PFS, Central Denials, Patient Access and Managed Care staff regarding contract...
oversight, management, and administration of the drafting, review, and negotiation of all system contracts with managed care... in the drafting, review and negotiations of critical/complex managed care, pharmacy and key transaction contracts...
. In this role, you will support a key modality within Gong's broader Professional Services org: Managed Services. This offering... all aspects of Managed Services engagements for Gong customers. Manage multiple customer programs to a defined scope, schedule...
in managed care experience preferred General working knowledge of the risk bearing organization and the delegated... over year, maximize client capitation revenue and manage client medical spend, coordinate the client team to ensure...
Description As part of the AWS Solutions organization, we have a vision to provide business applications, leveraging... stores. The role includes managing the intake, information collection, due diligence, onboarding, performance review...
Review, analyze, and report metrics to understand call volume, call disposition, average handle time, etc. and recommend... following: mortgage industry experience, application review and processing, customer-service related responsibilities...
Anticipated End Date: 2025-10-31 Position Title: Manager, Genetic Review Job Description: Manager, Genetic Review... Carelon Medical Benefit Management Genetic Testing Hybrid 2: This role requires associates to be in-office 3 days per week...
to perform a thorough medical necessity review. It is within the BH UM Reviewer’s discretion to retain requests for additional... management experience in a managed care organization preferred. Proficiency in Microsoft Office, including Word, Excel, Teams...
-jurisdictional matters, and consulting on workflow organization for Technology Assisted Review (TAR)-leveraged protocols; privilege... Review Manager is responsible for simultaneously managing multiple client matters as well as developing and initiating new...