…internal members of the health care team on case management and managed care concepts. Understands and focuses on key performance indicators. + Actively

…machine and mail. The Medicaid Special Programs Case Manager typically works in the telephonic managed care setting but may be called on to work from a variety

…Ensures compliance with federal and state regulations, MA Medicaid, Medicare and Managed Care payment systems. Monitors, consults, and makes effective

…a) Maintains a positive and professional relationship with payers that supports continued managed care contracts. b) Articulates the primary objectives of

…nursing facilities including the Alexian Village, ambulatory care facilities, home health care , physician practices, managed care services, and 4 cancer

…utilization and case management process. + 3 years' experience working in a managed care environment supporting utilization management and case review with

…Work or other healthcare related field. **Preferred Experience** + 10+ years managed care experience + Operational and process improvement experience **Preferred

…within the public region. Supports and coordinates medical services with Medicaid and Medicaid managed care programs as part of the LDH/OPH Program. Assures and

…acute care medical or surgical experience required;** **Utilization/Case Management, managed care , or Clinical Documentation and experience in** **ICD-10

…? Experience working in healthcare provider analytics related to revenue modeling, managed care contracting, population management, case management, clinical or