Managed Care Jobs in Long Beach
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Search Results - Managed Care Jobs in Long Beach
Blue Shield of California-Long Beach
Stars/Accreditation, Medicare Stars, Medi-Cal Managed Care Accountability Sets, Quality Transformation Initiative and Quality Rating System
• Partner with the HEDIS data team, Clinical Quality Analytics and Medical Record Review teams to support HEDIS...
Blue Shield of California-Long Beach
or correspondence. The CSC will interact telephonically with members as per established protocol or direction to ensure that members are effectively and efficiently managed through the medical/disease management process as needs require and in helping the RN care...
Blue Shield of California-Long Beach
or is in process of completing certification when eligible based on CCM application requirements
• Requires at least 5 years of prior experience in nursing, healthcare or related field
• A minimum of 3 years' experience in inpatient, outpatient, and/or managed care...
Blue Shield of California-Long Beach
Strong working experience in SAS.
• Requires at least 7 years of prior relevant experience with at least 5 years of experience in Health Care (managed care, academic, or gov't payer)
• Ability to work with all clinical coding systems strongly preferred...
Blue Shield of California-Long Beach
of prior operational and / or data analysis experience, experience in database structures, and standard query and reporting tools
• Requires at least 5 years of experience in Health Care (managed care, academic, or gov't payer)
• Requires at least 3 years...
Blue Shield of California-Long Beach
of completing certification when eligible based on CCM application requirements
• Requires 5+ years’ experience in nursing, health care or related field.
• 3+ years managed care experience preferred. Health insurance/managed care experience desired...
Blue Shield of California-Long Beach
Case Manager (CCM) Certification or is in process of completing certification when eligible based on CCM application requirements
• Requires at least 5 years of prior experience in nursing, healthcare or related field
• 3+ years managed care experience...
Blue Shield of California-Long Beach
years of experience in clinical pharmacy
• Experience working in a managed care setting and direct client and provider interface is preferred
• Demonstrated leadership skills/capabilities
• Thorough clinical knowledge regarding therapeutic use...
Blue Shield of California-Long Beach
in nursing, healthcare or related field
• 3+ years managed care experience preferred
• Requires relevant behavioral health experience
• Comprehensive knowledge of case management, discharge planning, utilization management, disease management and community...
SCAN-Long Beach
Experience in appeals and grievances review, utilization management, case review, and/or quality improvement activities in a managed care setting is strongly desired.
7. Strong knowledge of Medicare policies and guidelines is required.
8. Strong interpersonal...
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