Managed Care Jobs in Springfield
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Search Results - Managed Care Jobs in Springfield
Integrated Resources, Inc-Springfield
or Psychology OR LVN, LPN with 1 year experience in managed care systems OR RN OR 3 years care coordination for a state managed or waiver program OR 3 years managed care systems experience.
Knowledge of medical terminology
Experience coordinating member...
resume-library.com -
Springfield
requiring pre-authorization/pre-certification by Medicare, Medicaid, Commercial, and Managed Care payers, to ensure provider eligibility requirements are met prior to receiving service. Utilizes appropriate technology and/or communicates with physician...
icims.com -
Christus Health-Irving (IL), 43 mi from Springfield
the type, frequency, and duration of care.
Monitors key measures of program success and provides feedback re: opportunities to improve.
Requirements:
BSN Preferred.
3-5 years acute care/clinical experience; 2-3 years managed care and/or care management...
Springfield
and calculates write-off amounts and secures the necessary approvals from management for processing.
• Identifies accounts that require insurance pre-certifications and communicates with the insurance companies accordingly.
• Ensures compliance to managed care...
icims.com -
Springfield
the credentialing and verification process, streamline hospital privileging and support managed care credentialing.
Qualifications:
Education:
• Bachelor’s degree in business or health related field is desirable.
Licensure/Certification/Registry:
• Successful...
icims.com -
Springfield
certification by Medicare, Medicaid, Commercial, and Managed Care payers, to ensure provider eligibility requirements are met prior to receiving service. Utilizes appropriate technology and/or communicates with physician offices.
• Analyzes reports containing...
icims.com -
Springfield
departmental goals.
• Prioritizes scheduled patients in accordance with managed care pre-auth requirements and medical necessity requirements.
• Utilizes the account note function to record all telephone conversations, consultations, pertinent case specific...
icims.com -
Springfield
Overview:
Follows up on outstanding payments due on all types of open medical insurance claims, i.e., managed care and commercial. Coordinates activities with external insurance companies for the resolution of patient account balances.
Ensures...
icims.com -
Springfield
certification by Medicare, Medicaid, Commercial, and Managed Care payers, to ensure provider eligibility requirements are met prior to receiving service. Utilizes appropriate technology and/or communicates with physician offices.
• Analyzes reports containing...
icims.com -
Decatur (IL), 37 mi from Springfield
necessary.
• Other medical duties may be required from time to time as a result of the Center’s participation in the primary care network or affiliated managed care entities....
icims.com -
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