…unrestricted RN License in Texas . 2 to 5 years of experience in a managed care setting . Knowledge of the states federally funded healthcare programs: Medicare,

…discharge planning, utilization management, care management, performance improvement and managed care reimbursement + Knowledge of state and federal

… care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral

…+ Working knowledge of third party payor reimbursement - Medicare, Medicaid, Managed Care and commercial insurance. **Licenses and Certifications** **Working

…and review agreements and other documents, including: + Network collaboration agreements + Managed Care contracts + Complex software, SAAS, and other technology

…+ Working knowledge of third party payor reimbursement - Medicare, Medicaid, Managed Care and commercial insurance. **Licenses and Certifications** **Working

…to patient scheduling, registration and insurance verification + You will oversee center managed care contracts with third party payers including Medicare and

…pertinent to patient service and billing procedures: including basic knowledge of all managed care plans UPHS participates with and which insurers require a

…and authorization of level of care . + Offers input on managed care contracting issues, best demonstrated practices, process improvement and utilization

…timeframes. + Maintains comprehensive knowledge of reimbursement coverage from third party payers, managed care plans and protocols for referrals. + Ensures all