Managed Care Manager Jobs in Puerto Rico (NOW HIRING)

Descripción de Puesto - Care Manager CMS, Inc. y CMS Home Care - Llevando salud a través de todo Puerto Rico Somos la única compañía en Puerto Rico que ofrece un modelo integrado de servicios de ...

Nurse Care Manager I (NCLEX) Nurse Care Manager I Location: This role enables associates to workvirtually full-time, except for required in-person training sessions, providing maximum flexibility and ...

Nurse Care Manager I (NCLEX) Nurse Care Manager I Location: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility ...

Nurse Care Manager I Location: This role enables associates to workvirtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach ...

... care management, empowerment, motivational interviewing, services coordination and other clinically based activities as assigned, based upon member's severity of condition. 5. Educates the patient ...

Contacts managed care personnel when appropriate to obtain necessary initial authorizations * Notifies referring party if patient will require alternative discharge plan * Delegates specific tasks to ...

In this role, you will lead patient care in a collaborative environment, managing complex cases with the support of advanced practice providers, social workers, case managers, and other health ...

MMM Care Center Registered Nurse -Aibonito Diagnostic and Treatment Center (CDT) Care Center ... Non-Management Non-Exempt Workshift: Job Family: MED > Licensed Nurse Please be advised that ...

Works with client team to develop and implement action plan to address trends as appropriate Keeps current on insurance regulations, managed care contracts billing regulations, coding and fee ...

Experience in education, behavioral, managed care and/or health field preferred. Knowledge: * Knowledge and experience of education and prevention strategies. * Personal computer experience should ...

Managed Care or Medicaid coding experience.Associate degree in Health Information Management, Medical Coding, Healthcare Administration, or a related field (or equivalent experience). Excellent ...

Managed Care or Medicaid coding experience.Associate degree in Health Information Management, Medical Coding, Healthcare Administration, or a related field (or equivalent experience). Excellent ...

Track and document provider cases through resolution within CRM or tracking systems. * Support provider satisfaction initiatives and engagement strategies. EDUCATION * Bachelor's Degree in Healthcare ...

DaVita has an open position for a Healthcare Operations Manager (Facility Administrator) who must be an ambitious, operationally-focused and results-driven leader. You will directly impact patient ...

Act as liaison between managed care organizations and the facility professional clinical staff. * Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...

As part of said tasks, the Case Manager from time to time may have to also communicate with Doctors (Prescribers), Managed Care Organizations (MCO's) and authorized caregivers. Attention to precision ...

Knowledge of pharmacy industry or managed care compliance requirements and standards, preferred.

Knowledge of pharmacy industry or managed care compliance requirements and standards, preferred.

You'll work closely with Nurse Practitioners and RN Case Managers to coordinate care, facilitate resources, and keep the patient journey moving smoothly. Position Details: * Must be located in L.A

Managed care experience * Claims processing experience * Medical record familiarity * Experience in healthcare claims investigations * Experience in lean and/or six sigma methodology At UnitedHealth ...