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Cloverleaf Health Care Center —
Knightsville, Indiana,
United States
9325 S Crawford St, Knightsville, IN 47857, USA Cloverleaf Health Care Center is seeking a Licensed ... is to administer nursing care in a nursing home environment, under the supervision of a registered nurse ... : Administer nursing care in a nursing home environment under the supervision of a registered nurse or other
Reference no: 134648794
Posted on: 04/22/2021
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Healthfirst Inc. —
New York, NY,
Department of Health (NYSDOH) regulations governing medical management in managed care Relevant clinical ... The Case Manager, Utilization Management coordinates the care plan for assigned members ... . The Case Manager, Utilization Management is also responsible for efficient utilization of health services
Reference no: 1067147
Posted on: 04/22/2021
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Healthfirst Inc. —
New York, NY,
This position manages the domain's intake process for its application portfolio and is accountable ... for delivering a subset of it. The portfolio manager is a liaison between the application domain ... and the business stakeholders and is responsible for prioritizing the demand of application domain
Reference no: 1067148
Posted on: 04/22/2021
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Healthfirst Inc. —
New York, NY,
and their beneficiaries and works with clinicians and health care team members. The Care Manager facilitates care ... coordination of the member's health care services. The Care Manager is assigned to a specific product line ... with the multi-disciplinary health care team as necessary in order to ensure care plan goals are achieved
Reference no: 1067149
Posted on: 04/22/2021
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Healthfirst Inc. —
New York, NY,
and Individual Health Care Plans on behalf of the care/case managers. The Support Coordinator ... The Support Coordinator is responsible for assisting the care/case managers with non-clinical ... is assigned to a specific clinical team (such as Care Management, Utilization Management, Behavioral
Reference no: 1067150
Posted on: 04/22/2021
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California Correctional Health Care Services —
Not specified, California,
United States
of HMOs or Private Health Care Systems? At California Correctional Health Care Services (CCHCS) you ... of a multidisciplinary treatment team that provides you the freedom to focus on patient care without the burdens ... is a California State Department dedicated to providing quality medical, dental, and mental health
Reference no: 420061
Posted on: 04/22/2021
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California Correctional Health Care Services —
Not specified, California,
United States
of HMOs or Private Health Care Systems? At California Correctional Health Care Services (CCHCS) you ... of a multidisciplinary treatment team that provides you the freedom to focus on patient care, without the burdens ... is a California State Department dedicated to providing quality medical, dental, and mental health
Reference no: 420068
Posted on: 04/22/2021
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California Correctional Health Care Services —
Not specified, California,
United States
work-life balance? A career with California Correctional Health Care Services (CCHCS) allows you ... , dental, and mental health care in all 35 state-owned and operated adult correctional institutions ... to focus on providing quality care without the burdens of managing insurance paperwork or maintaining
Reference no: 420066
Posted on: 04/22/2021
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Healthfirst Inc. —
New York, NY,
Department of Health (NYSDOH) regulations governing medical management in managed care Relevant clinical ... The Case Manager, Utilization Management coordinates the care plan for assigned members ... . The Case Manager, Utilization Management is also responsible for efficient utilization of health services
Reference no: 1066603
Posted on: 04/21/2021
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Healthfirst Inc. —
New York, NY,
and their beneficiaries and works with clinicians and health care team members. The Care Manager facilitates care ... coordination of the member's health care services. The Care Manager is assigned to a specific product line ... with the multi-disciplinary health care team as necessary in order to ensure care plan goals are achieved
Reference no: 1066604
Posted on: 04/21/2021
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Healthfirst Inc. —
New York, NY,
Knowledge of at least two or more lines of business such as Medicare NY/NJ, Medicaid, Family Health Plus ... , Child Health Plus, NH Family Experience handling confidential information. Compliance & Regulatory ... The Quality Assurance Team Leader in Appeals and Grievances is responsible for managing
Reference no: 1066605
Posted on: 04/21/2021
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Healthfirst Inc. —
New York, NY,
A vital role of the CMO Administration team, the Dental Peer Reviewer plays a critical role ... in consulting on medical necessity in the context of dental appeals and ensuring adherence to internal ... Healthfirst and external regulations. Work Schedule: 25 hours a week - work must be performed between
Reference no: 1066606
Posted on: 04/21/2021
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Healthfirst Inc. —
New York, NY,
and their beneficiaries and works with clinicians and health care team members. The Care Manager facilitates care ... coordination of the member's health care services. The Care Manager plans and manages behavioral ... and/or physical care with members and their beneficiaries and works with clinicians and health care team
Reference no: 1066977
Posted on: 04/21/2021
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Healthfirst Inc. —
New York, NY,
(EP), Qualified Health Plan (QHP), Medicare or Complete Care. Customarily and regularly works away ... to educate potential members regarding the health benefits and care that is tailored for the member ... The Account Specialist is responsible for identifying prospective members who do not have health
Reference no: 1066978
Posted on: 04/21/2021
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Healthfirst Inc. —
New York, NY,
Care Services Agencies (LHCSA), Certified Home Health Agency (CHHA), Naturally Occurring Retirement ... on the frail adult and their Managed Long|Term Care (MLTCP) / Medicaid Advantage Plus (MAP) needs ... the Company and their Partners highly visible as an option for long|term care delivery. This position
Reference no: 1066979
Posted on: 04/21/2021
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Healthfirst Inc. —
New York, NY,
, actuarial, care and utilization management, claims, enrollment, marketing and other administrative ... , managed care, compliance, marketing/communications functions to ensure planning and execution ... and product management in the health plan industry Demonstrated management and leadership capabilities
Reference no: 1066980
Posted on: 04/21/2021
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Healthfirst Inc. —
New York, NY,
Health providers Familiarity with reimbursement methodologies (DRG, FFS, Capitation, APG, APC ... ) Experience with resolution of reported provider complaints Managed Care operations experience working ... experience with Hospital, Physician, Ancillary and/or Behavioral Health providers Familiarity
Reference no: 1066981
Posted on: 04/21/2021
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Healthfirst Inc. —
New York, NY,
with Hospital, Physician, Ancillary and/or Behavioral Health providers Proven experience ... , APC) Managed Care operations experience working with various business partners to facilitate ... and/or Behavioral Health providers Proven experience with provider complaint resolution Familiarity
Reference no: 1066982
Posted on: 04/21/2021
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Healthfirst Inc. —
New York, NY,
/ Provider Relations experience with Hospital, Physician, Ancillary and/or Behavioral Health providers ... cause analysis Managed Care operations experience working with various business partners to facilitate ... , Ancillary and/or Behavioral Health providers Familiarity with reimbursement methodologies (DRG, FFS
Reference no: 1066983
Posted on: 04/21/2021
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Healthfirst Inc. —
New York, NY,
to Care Management teams any inaccuracies found along with recommended solutions. - Communicates ... Health Information database (CCMS). - Documents any provider complaints and/or incidents upon ... such as medical records review; claims processing; managed care plan products (e.g. Medicaid, Medicare
Reference no: 1066984
Posted on: 04/21/2021
