…guidance and support to clinical new hires/preceptees in navigating within a Managed Care Organization (MCO) and provides coaching and shadowing opportunities

…health and social service agencies and additional community resources + Previous managed care experience + Bilingual preferred (Spanish, Arabic, Vietnamese or

…participation and transitions of care . + Knowledge /implementation of payer / managed care systems. + Knowledge/implementation of budget and department fiscal

…Performs facility credentialing and re-credentialing services in compliance with Commercial Managed Care organizations and Government Payors. Responsible for

…duty to warn mandates, knowledge of community-based resources and experience with Managed Care Organizations are all desirable. + Flexibility in approach

…to address critical access and affordability issues for patients + Partner with managed care colleagues to understand current policies and potential future

…Knowledge of and experience working with Provider Communities. + Medicare knowledge + Managed care experience + Proven ability to function effectively in matrix

…to Basic Life Support : Certified/certification eligible in relevant specialty, such as Certified Managed Care Nurse through the American Board of Managed

…+ You will provide medical consultation on contracting, pricing, and analysis of managed care issues. Offers clinical support for appeals and denials process,

…in sales with documented success + Experience working in a healthcare setting and/or managed care environment + Strong verbal and written communication skills +