Managed Care Jobs in USA

SUMMARY:Assists the Director of Finance with the preparation and monitoring of the multi-entity financial functions of the agency ensuring fiscal responsibility of the organization and the delivery of timely and accurate financial information. Responsible for preparation of moderate to complex accou...

Astrana Health is seeking a dedicated California-based Utilization Management (UM) Coordinator to support the UM department in reviewing monitoring and processing prior authorization requests while ensuring compliance with regulatory standards and health plan guidelines. The UM Coordinator will serv...

Who we are:Johns Hopkins Health Plans(JHHP) is the managed care and health services business of Johns Hopkins Medicine. JHHP is a $3B business serving over 500000 active members with lines of business in Medicaid Medicare commercial military health health solutions and venture investments. JHHP is a...

OverviewYou Matter Here!Heywood Healthcare values our employees! We offer competitive wages great benefits and generous earned time off. Come work where you will matter!Hours: 40-Hours Days 7:45am - 5:00pm Varying 8 hour shifts$21.25 - $31.22DisclaimerWe are committed to equitable and transparent co...

The Division Administrator reflects the mission vision and values of Northwestern Memorial HealthCare adheres to the organizations Code of Ethics and Corporate Compliance Program and complies with all relevant policies procedures guidelines and all other regulatory and accreditation standards.The Di...

Candidates will be hired at a level commensurate with their experience; this role will be filled at either grade 18 or grade 19. This is a field-based position and candidates should reside within a commutable distance of the posted city.The Parkinsons Disease (PD) Account Executive (AE) is responsib...

The Clinical Quality Leader RN TC reflects the mission vision and values of Northwestern Memorial Hospital adheres to the organizations Code of Ethics and Corporate Compliance Program and complies with all relevant policies procedures guidelines and all other regulatory and accreditation standards.T...

This role covers Arizona New Mexico West Texas (Austin Houston and San Antonio) and Colorado and supports key therapeutic areas including chronic migraine urology and spasticity and movement disorders.The Director of National Accounts is responsible for leading the strategic management of contract a...

This role covers Illinois Indiana Michigan and Wisconsin and supports key therapeutic areas including chronic migraine urology and spasticity and movement disorders.The Director of National Accounts is responsible for leading the strategic management of contract agreements with key national accounts...

The Utilization Management Registered Nurse is responsible for performing utilization review activities in compliance with federal and state regulations URAC standards and Guidehealth policies. This role applies established medical necessity criteria to obtain analyze and accurately document clinica...

This role is field-based and candidates should live within a reasonable distance from the primary city. Talent will be hired at a level commensurate with experience.Execute brand strategy and tactics in field sales performance effectively manage assigned territory and targeted accounts build strong...

Location:Geisinger Community Health Services & Sleep Disorder CenterShift:Days (United States of America)Scheduled Weekly Hours:40Worker Type:RegularExemption Status:YesJob Summary:Responsible for overall strategy planning development implementation and supervision of Enterprise Pharmacy managed car...

Contracts Payor AnalystBring your passion to Texas Health so we are Better TogetherWork Location:Texas Health Corporate 612 E. Lamar Blvd. Arlington TX 76011Work Hours:Full Time Days: (8:00am-5:00pm) for 40 hrs/week (Hybrid work allowed at managers discretion)Department Highlights:Hybrid PositionGa...

Location: Medical Center-ProsperDepartment:Admitting/RegistrationShift:Third Shift (United States of America)Standard Weekly Hours:40Summary:The incumbent will assist in providing access to services provided at the hospital and/or clinic. Knowledge of all tasks performed in the various Patient Acces...

NationsBenefits is recognized as one of the fastest-growing companies in America and a Healthcare Fintech provider of supplemental benefits flex cards and member engagement solutions. We partner with managed care organizations to provide innovative healthcare solutions that drive growth improve outc...

NationsBenefits is recognized as one of the fastest-growing companies in America and a Healthcare Fintech provider of supplemental benefits flex cards and member engagement solutions. We partner with managed care organizations to provide innovative healthcare solutions that drive growth improve outc...

NationsBenefits is recognized as one of the fastest-growing companies in America and a Healthcare Fintech provider of supplemental benefits flex cards and member engagement solutions. We partner with managed care organizations to provide innovative healthcare solutions that drive growth improve outc...

Department:01450 GCMG Pediatric Extended Care: Concord - Pediatrics: GeneralStatus: Full timeBenefits Eligible:YesHours Per Week:40Schedule Details/Additional Information:Evenings and EOWPay Range:$35.50 - $53.25Essential Functions Performs telephone triage with diverse patient population. Assesses...

Department:12707 Enterprise Corporate - Patient Access & Care Team: NC/GA NursingStatus: Part timeBenefits Eligible:YesHours Per Week:24Schedule Details/Additional Information:BSN required. 5 years of RN experience. Triage experience preferred. Needs to live within 50 miles of Mint Hill NC or Wake F...

JOB TITLEVice President Payor Strategy and RelationsPOSITION SUMMARYThe Vice President Payor Strategy & Relations leads Atlas Healthcare Partners strategy for payor reimbursement and relationships across its ambulatory surgery center (ASC) portfolio. This role works closely with health system partn...