…* Experience within a hospital or clinic environment, a health insurance company, managed care organization or other health care financial service

…ie, specialty medical office or Pharmacy Benefits Manager (PBM) **Skills:** + MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. + MUST HAVE 6 months of

…**Preferred Qualifications:** + Previous work experience in Appeals and Grievances in managed care plan products (eg Medicaid, Medicare, Commercial) and

…other projects, work, and activities as assigned by the Pharmacy Director Qualifications: + Managed Care experience preferred, but not required + Part D Coverage

…are not met to the Medical Director. + Demonstrates a working knowledge of managed care agreements based on available resources which may include UM Manual,

…union environment preferred; prior networking (relationship building) experience for either managed care or integrated delivery systems; demonstrated ability to

…responsibility through payment collection, cash handling, processing of insurance eligibility and managed care information. May also have direct patient care

…management techniques and applications; and Healthcare administration, including managed care administration, regulatory management, government regulations,

…direct patient care /clinical experience is required. + 2 years of experience in managed care is preferred. + Experience in the use of behavioral interviewing

…applications **Preferred Qualification** + Bachelor's Degree in Nursing + 3+ years of managed care experience + 3+ years of case management experienceBilingual;