…management, and approximately 1.5 million full risk covered lives through the company's managed care and health insurance services. The total number of paneled

…with medical surgical hospitals, community mental health centers, educational institutions, managed care organizations, local health professionals and agencies.

…and health information management principles, processes, methodologies and tools. Knowledge of managed care principles and of Medicaid, Medicare and Commercial

…Grifols medicines. The individual must possess a strong understanding of the managed care marketplace, large organized customers, medical policies, clinical

…criteria and documentation necessary for reimbursement; including Medicaid, Medicare, and Managed Care . Demonstrates leadership in the professional practice of

…appropriateness and quality of services provided. Maintain an awareness of overall concepts of managed care and make administrative judgments to ensure care

…to address gaps in care Job RequirementsRequired experience: o Complex Care Management/Case Management/ Managed Care experience o Community based or

…Collectors/Medical Billers! Responsibilities: The Collection Specialist analyzes and interprets Managed Care contract language, terms, conditions and

Establishes and maintains contracts with managed care companies and requests rate increases when deemed appropriate.Establishes contact with insurance and

…or related field - Licensed clinician - Psych RN, or LCSW, LMFT - Managed Care Experience required - 3+ years case and/or utilization management experience.