…adapt and the courage to innovate. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid

…Experience in Behavioral Health is a bonus. The clinical trainer will teach managed care and clinical concepts, systems navigation, and documentation processes.

…and dedicated Referral and Scheduling Coordinator, to prepare and process all managed care referral paperwork, schedules and pre-registers patients for exams

…located within Bay County. The MFC RN will work in collaboration with the Medicaid Managed Care Plan, the Community Based Agency and all others in the child's

…and revenue loss. Patient outcomes are achieved through effective application of care plans, managed care concepts, appropriateness criteria, resource

…year in Medical Management in a Health Insurance Plan; strong knowledge of managed care industry **LICENSES AND CERTIFICATION** **Required** + Medical Doctor or

…in a customer service role with financial responsibilities is required. Experience in health care , insurance, or managed care industries is highly preferred.

…areas highlighted by the OIG, Medicare, State Medicaid, State Insurance Fraud; Managed Care or Governmental Value-Based payment programs and/or other enforcement

…clinical charts, engaging in pre-audits of charts to ensure compliance with OASAS, managed care , and CARF standards. + Send weekly, monthly, and quarterly

…or exceeds standards set by the facility. + Educate patients on both clinical and managed care . + Participate in clinic and network task forces as requested and