…abreast of regulatory processes and payer systems such as Medicare, Medicaid, managed care , and private sources, as applicable. Demonstrate extensive advanced

…new services and/or programs. Interfaces and coordinates services with Admission, Finance, Managed Care , Medical Records, Home Care , Rehabilitative and

… plan as needed. Contact the physician with changes in the patient condition. Managed Care patients o Update case management department with patient status in

…working with developmental disabilities population + Medicare and Medicaid experience + Managed care experience **SKILLS** + Working flexible hours to meet

…Experience: + Minimum two years of experience in health related field required + Care management and/or managed care experience preferred + Proficiency in

…benefits, communication of information to insurance company, billing certifications, concurrent managed care denial appeals and retrospective medical record

…application of positive language principles + Knowledge of Medicare, Medicaid and Managed Care requirements + Progressive knowledge of community resources,

…and projects with demonstrated outcomes + 4+ years demonstrated experience in managed care Utilization Management to include prior authorization, concurrent

… management services for participants. + Incorporates nutritional information as part of managed care benefits. + Researches new resources and provides education

…skills. You will work collaboratively with the patient, community resources, other providers, managed care operations, the UCLA Health System, and health plans