…services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed

…information utilizing internal or electronic sources. + Obtains and documents managed care referrals, required pre-certifications and authorizations as necessary

…by communicating medical information required by all external review entities, managed care contracts, insurers, fiscal intermediaries, state, and federal

…and Provider Services, Healthcare Eligibility and Access, Integrated Health Partnerships, Managed Care , and other Medicaid divisions throughout the agency

…Minimum of two years of Sales, outreach, and/or community relationship within a managed care environment required. Minimum of two years' experience in a

…in the health care field including, but not limited to, provider's office, managed care organization, or other health care environment. * 3+ years

…Experience in a related setting using medical/psychiatric terminology and working with managed care and Behavioral Health carve outs is preferred. COMPETENCIES:

…acute care /medical experience. 1-3 years in case management, disease management, managed care or medical or behavioral health settings. **REQUIRED LICENSE,

…Nursing preferred. **Required Experience** 1-3 years in case management, disease management, managed care or medical or behavioral health settings. **Required

…contracting issues. + Provides medical consultation on contracting, pricing, and analysis of managed care issues. Offers clinical support for appeals and denials