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Care Manager
1 week ago
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In Home Care, Client Care Manager
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rn care manager
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Presbyterian Healthcare Services Albuquerque, NM , USA, United StatesOverview · Type of Opportunity: Per Required NeedFTE: Exempt: NoWork Schedule: Days · We're all about well-being, starting with yours.Presbyterian employees have access to a fun, engaging and unique wellness program, including free on-site and community-based gyms, nutrition coac ...
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RN Care Manager
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Care Manager, BH
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Care Manager, BH
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Magellan Health Albuquerque, United States100% Remote, Must be a NM resident. · Under general supervision, and in collaboration with other members of the clinical team, authorizes and reviews utilization of mental health and substance abuse services provided in inpatient and/or outpatient care settings. Collects and ana ...
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Director of Managed Care
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HME Specialists LLC Albuquerque, United StatesJob Description · Job DescriptionAbout the job · HME Specialists is a fast growing primary player in NM providing Durable Medical Equipment, Home Infusion and LTC/Hospice services · The Director of Managed Care & Contracting will oversee strategy and development for all Managed C ...
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Caregiver/Care Manager
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Managed Care Analyst
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Care Manager- LVN LPN
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Manager, Clinical Care Services
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Community Care Case Manager
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Adobe Population Health Albuquerque, United StatesJob Description · Job DescriptionABOUT APH · Adobe Population Health (APH) is a women-owned health solutions company founded in 2018 and committed to positively impacting the lives we touch. The company has a culture of inclusivity and human kindness, based in Phoenix, AZ, with s ...
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RN Care Management Supervisor
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University of New Mexico - Hospitals Albuquerque, NM, United States Full timeUNM Hospitals participates in the Clinical Advancement Program (CAP) and depending on your Nursing Education and National Certifications, you'll work towards one of five CAP levels that offer increasing compensation. Sign-on Bonus and Relocation Reimbursement available · Departme ...
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Social Care and Community Manage
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MEDSHINE New Mexico, United States Full timeAre you a BE/BC Pain Management Physician looking for an exciting new opportunity in a dynamic medical community? Our cutting-edge healthcare organization is seeking a Pain Management Physician to join an established medical facility in Chaves County, NM. · As our Pain Managemen ...
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Dialysis Clinical Manager Registered Nurse
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Fresenius Medical Care Albuquerque, United States Full timePOSITION FEATURES: · Float position · Albuquerque Area · About this role: As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. As the facility leader, you will be part of a close-knit, col ...
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Dialysis Charge Registered Nurse
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Fresenius Medical Care Albuquerque, United States Full timePOSITION FEATURES: · This job requires frequent travel between facilities in Albuquerque, Rio Rancho, and Santa Fe, Clovis, and Los Lunas · PURPOSE AND SCOPE: · Works with the Facility Manager, facility staff and physician to coordinate the facility operations and patient proced ...
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Research Associate
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Actalent Albuquerque, United States Full timeDescription: · Research Associate will conduct experiments and contribute to the development of our TBI product using modern immunochemical techniques under the supervision of the Senior Scientist and/or Director of Assay Development.Responsibilities:- Plan and execute experiment ...
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Dental Assistant
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Memory Care Manager, LPN Required
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Palmilla Senior Living Albuquerque, United StatesCompany Description · At Spectrum Retirement Communities we believe in living without limits, in aging fearlessly, and in sharing great stories. The Spectrum Story is full of compassion, hard work, and fun. If the chapters of your life story include caring for others and a dedica ...
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Research Associate
2 weeks ago
Actalent Albuquerque, United States Full timeDescription: · Research Associate will conduct experiments and contribute to the development of our TBI product using modern immunochemical techniques under the supervision of the lead Scientist and/or Director of Assay Development. · Responsibilities: · Plan and execute experime ...
Director of Managed Care - Albuquerque, United States - Home Medical Equipment Specialists, Llc
Description
About the jobHME Specialists is a fast growing primary player in NM providing Durable Medical Equipment, Home Infusion and LTC/Hospice services
The Director of Managed Care & Contracting will oversee strategy and development for all Managed Care Services and Contracting for the LTC and New Vista lines of business.
The Corporate Director is responsible for full managed care contract life-cycle support, including new business and revenue development through continued clinical integration and market expansion.
Job duties & responsibilitiesDevelop, negotiate, and implement new and ongoing payor strategies, models, and partnerships that support HME revenue and margin growth
Proactively identify and engage target payors who are candidates for innovative partnership that maximize HME Specialists ability to provide services to all patients regardless of insurance
Deliver improved payor satisfaction through the execution of strategic programs and assisting in reporting on patient care to managed care partners.
Assist with claims escalation processes with payer partners
Leads and assists with RFP's.
Support and educate Case Management
Serves as a subject matter expert on contract and reimbursement-related issues impacting our industry and healthcare industries, particularly with a managed care and commercial reimbursement focus.
The qualified candidate will have extensive knowledge and relevant work experience in the Managed Care/insurance sectors including network planning/development, contract negotiations, etc.
This position reports to the VP of Sales and Business Development.
Experience
Experience in Managed Care contracting for a multi-site Ancillary Healthcare Provider desired.
2 years of healthcare contracting experience required.
Bachelors degree preferred
Experience with Medicare Licensure preferred.
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