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

…contracts) to assess financial performance, revenue generation, and profitability. Analyzes managed care contracts for compliance and financial performance,

…Health Organization, County, and/or MCO contracts with the ability to tier clients in a managed care system. The ability to work effectively with all persons and

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

…skills are required as well as knowledge of working with community agencies and managed care representatives is desired. + Experience working with a diverse

…and familiarity with evidenced based practices, case management, utilization review, discharge planning, home care , and / or managed care + Strong knowledge

…insurance and benefit information. Verify insurance and benefits for Medicare, Medicaid, Managed Care , and Workers Comp and Commercial Plans. Securing

…leadership team under the direction of the Director. **Scope** : UTMB Correctional Managed Care Operations and Clinics **ESSENTIAL JOB FUNCTIONS** + Oversees and

…third-party health care coverage experience, and a strong understanding of managed care regulations are preferred. + Experience with personal computer-based

…experience LPN/LVN with current unrestricted state licensure **Preferred Qualifications** Managed Care experience preferred **Education** LPN/LVN with current