Managed Care Jobs in San Jose
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Search Results - Managed Care Jobs in San Jose
San Josepacificclinics.org
based practices to support Community School efforts.
Reports to the CPM or Program Administrator and support them in administration functions of the program. This position plays a critical role engaging potential customers in managed-care and similar...
Molina HealthcareSan Jose
managed care, or equivalent combination of relevant education and experience.
• Registered Nurse (RN). License must be active and unrestricted in state of practice.
• Ability to prioritize and manage multiple deadlines.
• Excellent organizational...
Samsung Electronics AmericaSan Jose
and Google Chrome
• Familiarity with clinical and economic outcome data, reimbursement, and managed care policies and procedures is highly desirable
• Must be able to assemble facts from various areas, analyze data, and provide informed recommendations...
Molina HealthcareSan Jose
health care experience, and at least 5 years of managed care experienced in one or more of the following areas: utilization management, care management, care transitions, behavioral health, long-term services and supports (LTSS), or equivalent combination...
Samsung Electronics AmericaSan Jose
demonstrate proficiency with MS Office package, including Excel, Word, and PowerPoint; as well as Outlook, Internet Explorer, and Google Chrome
• Familiarity with clinical and economic outcome data, reimbursement, and managed care policies and procedures...
Pacific Health GroupSan Joseworkable.com
monitors pending applications, follows up on eligibility issues, assists with denied or discontinued coverage, supports appeals and submission of requested documentation, helps members navigate Managed Care Plan enrollment, and tracks each case until...
Heartland HospiceSan Jose
resources; good oral and written communication skills; documentation and program management; knowledge of general nursing practice; thorough knowledge of managed care principles, regulatory guidelines (i.e., Medicare, Medicaid, ACHC, and human resource...
San Joseicims.com
or Managed Care setting
• Associate’s degree in Nursing from an accredited institution required
• Bachelor’s degree in Nursing from an accredited institution preferred
• Possession of valid Certified Site Reviewer Certificate issued from DHCS or participating...
McKessonIrving, 1436 mi from San Jose
within clinical teams in managed care pharmacy, pharmacy consulting, health system, or pharmacy benefit manager environments * Previous technical work experience with Microsoft Office Suites, data visualization software, data analytics reporting...
San Joseicims.com
and functions as a resource to the clinical team regarding approved criteria, practice guidelines and alternative treatment options.
Responsibilities:
ESSENTIAL FUNCTIONS:
• Act as liaison between managed care organizations and the facility professional...
Pacific Health GroupSan Joseworkable.com
behavioral health services while expanding access to care through innovative community engagement, street outreach collaboration, and integrated care initiatives. The Program Manager partners closely with executive leadership, county agencies, managed care...
San Joseicims.com
and maintaining effective provider relationships. The Specialist will work closely with the Medical Director (MD), Associate Medical Director (AMD), and the Contracting & Managed Care Officer (CMCO).
Responsibilities:
Performance Area 1: Provider Account...
Innovativ Pharma, Inc.San Joseworkable.com
grant/education proposals, etc. for key customers).
• Gain formulary acceptance/compliance with managed care accounts.
• Scientific understanding of clinical papers.
• Utilize consultative skills in assisting customer with their business
• Market...
San Joseicims.com
including conducting and managing a continuous quality improvement project in a healthcare environment, safety, and relevant managed care and clinical experience.
SKILLS
• Able to quickly build and maintain rapport with patients and providers...
Pacific Health GroupSan Joseworkable.com
Verify MediCal eligibility and aid codes for all Clubhouse members monthly (and prior to claiming), including share-of-cost, other health coverage (OHC), and managed care assignment issues that affect SMHS claiming.
• Coordinate resolution of eligibility...
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