…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

…experience Knowledge of health care issues, trends, legal compliance and managed care with emphasis in all components and nursing operations. Ability