…nursing experience and 1+ years of utilization management experience in a managed care setting. Knowledge of utilization management principles and healthcare

…year experience in the health care field (preferably in a managed care setting)Must have experience researching, compiling and organizing information from

…quality home health care to adult and geriatric Veteran, Medicare, Medicaid and Managed Care patients in their homes and in the community. The Nurse Case

…management and communication of denials/appeals received from third party payers, managed care companies, and/or government entities/auditors related to medical

…FHCB. Participates in the development and execution of contracts and agreements with managed care organizations, insurance companies, other health care

…provide quality assurance oversight of all aspects of Behavioral Health programs including Managed Care and Medi-Cal Specialty Mental Health services, as well as

…such as a federal or state agency, institution, hospital, academic health science center, or managed care organization. 6. At least 2 years of which must have

Risico Total Managed Care , Inc. (Risico) is seeking a qualified Medical Management Nurse to join the Risico Team in our Fresno office. We are very excited about

Director, Grievance and AppealsLeadership opportunity within a growing managed care organization. Requirements:7 years’ experience in healthcare claims review

…and update insurance companies on admissions, discharges and changes in condition for managed care residents Attend and participate in weekly Medicare meetings