…State of Nevada. Experience: Minimum of three years as a practicing pharmacist, in a managed care setting preferred (working knowledge of managed care ,

CHIEF, HEALTH INSURANCE AND MANAGED CARE Recruitment #20-009646-0001 Department Maryland Insurance Administration Date Opened 1/10/2020 3:45:00 PM Filing

…Nurses Credentialing Center. Overview Role Purpose In conjunction with the Vice President, Managed Care , execute the payer contracting strategy which has been

Healthcare Plans Finance Director, Managed Care Full-time Company Description Clients are general acute care hospitals nationwide. Southern Medical

JOB SUMMARY The Pharmacy Manager of Managed Care and Pharmacy Contracts is responsible for developing relationships and expanded thir party payer prescriptions

…least four years working in positions of increasing responsibility in a healthcare or managed care setting, preferably with familiarity with large data sets and

…monitoring tools- InterQual, Milliman Care Guidelines (MCG), principles of Managed Care , Computer applications, including but not limited to: Windows,

…care coordination and transitional planning; hospital denials and appeals; experience in managed care , commercial payer guidelines and business care

… and medical necessity according to criteria established by TMF, Medicare, Medicaid, Managed Care agencies, and Clinical Path resources [Interqual, M&R]. Such

…planner, UR nurses, physicians, and other key hospital personal,physician groups, managed care organizations, and other community organizations with referral