…regarding the patient's care to include ensuring compliance with managed care , commercial insurance, and public insurance requirements, submitting and

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

…equivalent experience. **Required Experience** At least 7 - 10 years of experience in Managed Care and/or health plan quality. Clinical experience is needed for

…of provider relations, provider claims/reimbursement, or contracting experience. Knowledge of health care , managed care , Medicare or Medicaid. Bachelor's

…decision-making skills. + Knowledge of insurance regulations, specifically Medicare, BC/BS, managed care plans and workers compensation carriers regarding

…experience in the healthcare industry or working in health systems, hospitals, managed care organization, government agencies or other management settings.

…Spectrum has a seat at the table with healthcare systems, employers, insurers, managed care organizations, and policymakers. When it comes to making decisions

…Psychiatry) + Board Certified + Current DEA registration + Experience in a primary care specialty, corrections, and/or managed health care delivery + Must

…IN:** Experience within a hospital or clinic environment, an insurance company, managed care organization or other financial service setting, performing

…offers a full continuum of care including Transitional Care , Enhanced Care and Assisted Living/Memory Care . Managed by Ebenezer, we offer employees