Managed Care Finance Director jobs in Wisconsin

Managed Care Finance Director directs and oversees all policies and procedures for the financial and data operations of managed care contracts. Manages contracts, negotiates and sets rates, and reviews reimbursement levels and managed care agreements to ensure that proper payment practices are utilized. Being a Managed Care Finance Director implements processes that encourage and inform the organization how to increase levels of reimbursements. Requires a bachelor's degree. Additionally, Managed Care Finance Director typically reports to top management. The Managed Care Finance Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. To be a Managed Care Finance Director typically requires 5+ years of managerial experience. (Copyright 2024 Salary.com)

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RN Care Manager
  • Managed Health Services Wisconsin
  • Racine, WI FULL_TIME
  • You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. * We are currently offering a $5,000 sign-on bonus for this position * ** This hybrid remote role requires less than 50% travel in Milwaukee / Appleton area and candidates will have the flexibility to work remotely from their home the remaining time ** Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care. • Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options • Utilize assessment skills and discretionary judgment to develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs and promote desired outcomes • Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients • Provide patient and provider education • Facilitate member access to community based services • Monitor referrals made to community based organizations, medical care and other services to support the members’ overall care management plan • Actively participate in integrated team care management rounds • Identify related risk management quality concerns and report these scenarios to the appropriate resources. • Case load will reflect heavier weighting of complex cases than Care Manager I, commensurate with experience • Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems • Direct care to participating network providers • Perform duties independently, demonstrating advanced understanding of complex care management principles. • Participate in case management committees and work on special projects related to case management as needed Education/Experience: Graduate from an Accredited School of Nursing. Bachelor’s degree in Nursing preferred. 2 years of clinical nursing experience in a clinical, acute care, or community setting and 1 years of case management experience in a managed care setting. Knowledge of utilization management principles and healthcare managed care. Experience with medical decision support tools (i.e. Interqual, NCCN) and government sponsored managed care programs.Licenses/Certifications: Current state’s RN license and a valid driver's license Pay Range: $66,100.00 - $118,900.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

    About the Company:
    Managed Health Services Wisconsin



  • 1 Month Ago

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RN Care Manager
  • Managed Health Services Wisconsin
  • Carlton, WI FULL_TIME
  • You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offeri...
  • 1 Month Ago

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RN Care Manager
  • Managed Health Services Wisconsin
  • Nelson, WI FULL_TIME
  • You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offeri...
  • 1 Month Ago

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Care Manager II (RN) - Now Hiring
  • Managed Health Services WI
  • Kansasville, WI FULL_TIME
  • You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offeri...
  • 2 Days Ago

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MANAGED CARE CONTRACT COORD, FCH - MANAGED CARE
  • Froedtert Health
  • Menomonee Falls, WI FULL_TIME
  • Discover. Achieve. Succeed. #BeHere Location: US:WI:MENOMONEE FALLS at our WOODLAND PRIME 400 facility. This job is HYBRID.FTE: 1.000000Shift: 1st shift 8 am to 4:30 pm onsite Tuesday and Wednesday th...
  • 1 Month Ago

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Managed Care Coordinator
  • Family Health Center of M
  • Ladysmith, WI FULL_TIME
  • The Managed Care Coordinator completes insurance requirements and provides case management as needed for services performed in various patient seeing settings. The individual obtains and provides insu...
  • 6 Days Ago

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Finance Director (CFO Path!)
  • Creative Financial Staffing
  • Boston, MA
  • Creative Financial Staffing has partnered with a very well-established firm in the Real Estate industry in the search fo...
  • 4/19/2024 12:00:00 AM

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VP, Chief Finance Officer
  • WVU Medicine Thomas Hospitals
  • South Charleston, WV
  • Provides executive management support in planning, organizing and directing fiscal related functions to include financia...
  • 4/19/2024 12:00:00 AM

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CFO
  • Creative Financial Staffing
  • Cambridge, MA
  • An international Fitness and Sports Event company has exclusively retained Creative Financial Staffing to identify a VP ...
  • 4/18/2024 12:00:00 AM

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CFO / Controller
  • Creative Financial Staffing
  • Kemah, TX
  • About the Small Company CFO Opportunity: Work hand in hand with leadership team of a $180M company (it was 70M two years...
  • 4/17/2024 12:00:00 AM

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VP of Finance/CFO
  • Creative Financial Staffing
  • Boston, MA
  • An international Fitness and Sports Event company has exclusively retained Creative Financial Staffing to identify a VP ...
  • 4/17/2024 12:00:00 AM

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Senior Finance Director (Division CFO)
  • Korn Ferry
  • Houston, TX
  • Korn Ferry Professional Search has partnered with our client on their search for a Divisional CFO. This position will be...
  • 4/16/2024 12:00:00 AM

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Finance Director
  • Orthosouth - Orthopedic Care
  • Memphis, TN
  • This position reports to the CFO. GENERAL DESCRIPTION & PURPOSE Will oversee the daily operations in the Accounting depa...
  • 4/16/2024 12:00:00 AM

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Chief Finance Officer (Healthcare)
  • Callen-Lorde Community Health Center
  • New York, NY
  • Job Description Job Description Are you ready to make a profound impact on the world of LGBTQ+ healthcare and lead a dyn...
  • 4/15/2024 12:00:00 AM

Wisconsin is bordered by the Montreal River; Lake Superior and Michigan to the north; by Lake Michigan to the east; by Illinois to the south; and by Iowa to the southwest and Minnesota to the northwest. A border dispute with Michigan was settled by two cases, both Wisconsin v. Michigan, in 1934 and 1935. The state's boundaries include the Mississippi River and St. Croix River in the west, and the Menominee River in the northeast. With its location between the Great Lakes and the Mississippi River, Wisconsin is home to a wide variety of geographical features. The state is divided into five dist...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Finance Director jobs
$140,926 to $182,095

Managed Care Finance Director in Waterloo, IA
Today, the Department of Health Care Finance (DHCF) announced that the Office of Contracting and Procurement (OCP) submitted to the Council of the District of Columbia a notice of intent to award three contracts for the District’s Medicaid managed care program.
January 27, 2020
Managed Care Finance Director in Biloxi, MS
Our executives lead the strategies and operations that help us deliver quality care across our network.
January 30, 2020
Managed Care Finance Director in Reno, NV
Facey Medical Group is a multi-specialty medical group with over 160 physicians providing care to the growing population in the North & East regions of Los Angeles & Ventura Counties.
December 30, 2019
Able to travel to all regional sites in a consistent, timely and efficient manner; holds effective meetings and leads workgroups, assigns and takes over deliverables, reports to and coordinates with the regional director and manager on the priorities and workload management; strives to exceed expectations.
January 24, 2020