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Providence St. Joseph Health
Renton, WA, United States
Description Responsible for maintaining and updating the GE/Centricity/IDX Managed Care Application (MCA) module for US Family Health Plan's managed care line of business: builds fee schedules, provider and vendor dictionary entries, and plan benefits and exclusions. Assists with health plan utilization management reporting for the organization. Re
Job Source: Providence St. Joseph HealthProvidence St. Joseph Health
Renton, WA, United States
Description Adjudicates claims submitted by outside purchased services for PMC's enrolled capitated population and communicates those actions. Adjusts complex claims for advanced processing needs. Responds to Customer Service Requests and resolves problem claim situations. Providence caregivers are not simply valued - they're invaluable. Join our t
Job Source: Providence St. Joseph HealthProvidence Health & Services
Seattle, WA, United States
Description Coordinates care for Pacific Medical Centers' Managed Care patient in order to assure cost effective, appropriate utilization of health care resource. Nurse Case Manager manages, directs, and coordinates the entire spectrum of care for patient throughout a variety of settings, both inpatient and outpatient. This position assists physic
Job Source: Providence Health & ServicesPacific Medical Centers
Seattle, WA, United States
Search for City, State, Country, Zip Code Care Manager RN - USFHP | Pacific Medical Center Jobs Description Coordinates care for Pacific Medical Centers' Managed Care patient in order to assure cost effective, appropriate utilization of health care resource. Nurse Case Manager manages, directs, and coordinates the entire spectrum of care for patie
Job Source: Pacific Medical CentersProvidence St. Joseph Health
Seattle, WA, United States
Description Open positions for PacMed Seattle Clinic and PacMed Renton Clinic locations The USFHP Enrollment Coordinator performs enrollment, eligibility, and premium payment activities for beneficiaries. The coordinator researches and resolves eligibility questions, disenrolls members who have lost eligibility and notifies enrollees of changes in
Job Source: Providence St. Joseph HealthProvidence Health & Service
Seattle, WA, United States
Job Description Open positions for PacMed Seattle Clinic and PacMed Renton Clinic locations The USFHP Enrollment Coordinator performs enrollment, eligibility, and premium payment activities for beneficiaries. The coordinator researches and resolves eligibility questions, disenrolls members who have lost eligibility and notifies enrollees of chang
Job Source: Providence Health & ServiceProvidence Health & Services
Seattle, WA, United States
Description Open positions for PacMed Seattle Clinic and PacMed Renton Clinic locations The USFHP Enrollment Coordinator performs enrollment, eligibility, and premium payment activities for beneficiaries. The coordinator researches and resolves eligibility questions, disenrolls members who have lost eligibility and notifies enrollees of changes i
Job Source: Providence Health & ServicesProvidence Health & Service
Seattle, WA, United States
Job Description Open positions for PacMed Seattle Clinic and PacMed Renton Clinic locations The USFHP Enrollment Coordinator performs enrollment, eligibility, and premium payment activities for beneficiaries. The coordinator researches and resolves eligibility questions, disenrolls members who have lost eligibility and notifies enrollees of chang
Job Source: Providence Health & ServiceRenton, WA, United States
Description (This position will be in person for the first 90 days. After 90 days, may be eligible to work from home, 1-2 times a week) Supports and works collaboratively with internal and external groups to support our commitment to high-quality, value-based care. The Population Health Coordinator operates in a highly autonomous manner, utilizes a diverse set of problem solving skills, and is able to navigate multiple data sources to obtain documentation to close gaps in care and improve quality metrics. Under the guidance of the Quality Manager and/or Quality Analyst, reviews quarterly performance reports, meets with network group representatives, and develops detailed action plans to ensure data is obtained to close gaps in care. This position provides support for HEDIS activities, HCC coding audits, TRICARE reports, quality measure reports for provider groups, and reports to support utilization and enrollment activities. Providence caregivers are not simply valued - they're invaluable. Join our team at Pacmed Clinics DBA Pacific Medical Centers and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Required Qualifications: Driving may be necessary as part of this role. Caregivers are required to comply with all state laws and requirements for driving. Caregivers will be expected to provide proof of driver license and auto insurance upon request. See policy for additional information. 2 years Customer service related experience. Prior experience using Excel spreadsheets. Prior experience with an EMR. Preferred Qualifications: Associate's Degree Healthcare related field. 1 year experience with coding: ICD-10, CPT, HCPCS. Why Join Providence? Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering our mission to advocate, educate and provide extraordinary care. About Providence At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Check out our benefits page for more information about our Benefits and Rewards. About the Team Pacific Medical Centers (PacMed) is a private, not-for-profit, primary and integrated multi-specialty health care network with outpatient clinics and primary and specialty care providers in King, Snohomish and Pierce counties. We combine decades of patient-centered care with cutting-edge technology, first-class facilities and board-certified providers. Our strong team environment and respect for our people-at all levels and from all backgrounds-allow us to provide authentic care that achieves the highest-quality patient outcomes, backed by the strong network of resources and support through our affiliation with the P
Email Alert for Patient Liaison - USFHP jobs in Renton, WA, United States
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