- Henry Ford Health System (Troy, MI)
- GENERAL SUMMARY: Reporting to the Director - Managed Care Contracting , this position is responsible for managing the payor contracting functions for ... Ford Health. This position is responsible for leading the Managed Care Contracting team in...team accountable for completing work accurately and timely. Keep Director informed on issues and progress. 7. Maintain contracts,… more
- University of Michigan (Ann Arbor, MI)
- …society. **Responsibilities + Support Manager, Managed Care Operations and Senior Director , Managed Care Contracting and Operations with payer ... Managed Care Payer/Operations Analyst Apply Now **Job Summary** The Managed Care Contracting and Operations (MCCO) Department is responsible for the… more
- e CancerCare (Nashville, TN)
- …(ex. Blue Cross, Blue Shield, IPA, etc). Reporting to the Director of Managed Care , the Manager of Contracting is responsible for managing legal ... Job Purpose: Manager of Payor Contracting is responsible for reviewing, auditing and negotiating...negotiation with strategy. Essential Functions: In collaboration with the Director of Managed Care , negotiate… more
- Ascendis Pharma (Princeton, NJ)
- …administration of rebate programs, including government rebates (eg, Medicaid, Medicare), managed care rebates, and commercial rebates. Ensure accurate ... formulary validation processes accurately and before payment deadlines, oversee payments of managed care and government rebates, and manage Market Access… more
- Stanford Health Care (Palo Alto, CA)
- …lines in the development and facilitation of business development strategies relative to managed care contracting . + Performs special projects on behalf ... productive working relationships with internal and external customers to support managed care strategy, contracting and operational effectiveness. + Responds… more
- The Cigna Group (San Diego, CA)
- …relationships with provider partners. + Intimate understanding and experience with hospital, managed care , and provider business models. + Team player with ... **_position aligned to the San Diego, CA market._** The ** Director ,** **Provider Contracting ** serves as an integral...of life. We guide our customers through the health care system, empowering them with the information and insight… more
- Scripps Health (San Diego, CA)
- …fee-for-service, partial risk, and full global risk HMO, PPO, and Ancillary services managed care agreements with health plans on behalf of Scripps Health's ... actively engage in the analysis, management, accounting, and budgeting of all managed care agreements. Establish effective lines of communication between Payer… more
- The Cigna Group (Scottsdale, AZ)
- …relationships with provider partners. + Intimate understanding and experience with hospital, managed care , and provider business models. + Team player with ... with Providers AND several days work at Home_** The ** Director , Provider Contracting Network Management** serves as...of life. We guide our customers through the health care system, empowering them with the information and insight… more
- National Health Care Associates (Wethersfield, CT)
- …long-term care and short-term rehabilitation services in the Northeast US, is seeking a Director of Managed Care . This is a fantastic opportunity for the ... the Northeast! **ESSENTIAL DUTIES, RESPONSIBILITIES, LEADERSHIP:** + Oversight of Managed Care relationships. + Oversee managed...preferred (MHA, MBA) + 8+ years of experience in contracting , case/ care management, and profit and loss… more
- CVS Health (Downers Grove, IL)
- …based on experience. **Required Qualifications** *A minimum of 8 years experience in managed care which may include PBM, Pharma, market access, account ... to increasing access, lowering costs and improving quality of care . In this Director level role you...on high-value rebate contracts for Commercial, Health Exchange, and Managed Medicaid segments. This includes management of the business… more
- Fairview Health Services (St. Paul, MN)
- … care payor terms and relationships. + Develop, recommend, and oversee annual managed care negotiation parameters and contracting plans and execute ... Management, Finance **Experience** *10+ years of healthcare experience in managed care , negotiating and contracting for integrated delivery systems.… more
- CVS Health (Downers Grove, IL)
- …assigned manufacturers. **Required Qualifications** + A minimum of 8 years experience in managed care which may include PBM, Pharma, market access, account ... to increasing access, lowering costs and improving quality of care . In this Director level role, you...contracts and value based agreements for Medicare Part B, Managed Medicaid, and Commercial segments. This includes management of… more
- VNS Health (Manhattan, NY)
- …Experience:Minimum ten years' experience in health care , with a minimum eight years in managed care provider contracting and a minimum of two years in ... VNS Health's Health Plan Physician, Ancillary, Hospital provider networks. Includes contracting , rate setting, monitoring for and maintaining network adequacy of all… more
- Dignity Health (Bakersfield, CA)
- …care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups hospitals ... **within California** **.** Working in a collaborative environment, the Director will be a hands-on leader to the Enrollment...growth of the department. Experience with IPA or network managed care , EZCAP and analytics strongly preferred.… more
- MaineGeneral Health (Waterville, ME)
- …We are actively seeking a finance professional to join our experienced team as the Director of Reimbursement and Managed Care who will oversee all aspects ... of reimbursement, managed care contracts, and payer enrollment. The successful candidate will...and manage payer relationships + Utilize Sorian and StrataJazz contracting modules + Perform contract modeling and troubleshoot payer… more
- State of Colorado (Denver, CO)
- …and provide support to leadership and staff for various managed care enrollment/eligibility activities. * Oversee RAE provider contracting operations and ... Managed Care Technology Administrator Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4730377)...process may request a review by the State Personnel Director . As an applicant directly affected by the results… more
- The Cigna Group (Trenton, NJ)
- …Principal Negotiator will report to the Sr. Director Strategy & Contracting and focus on Pharma industry/ Managed Markets/Specialty Knowledge PBM/Health plans ... health plan clients. **ESSENTIAL FUNCTIONS** + Assisting the Sr. Director of Pharma Strategy and Contracting in...Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase… more
- Mitsubishi Chemical Group (Jersey City, NJ)
- …leader that is responsible for oversight, leadership, management, and tactical execution of the Managed Care team. This person will focus and direct the strategy ... therapy and future products in the United States. The Director will be responsible for holding the team accountable...future products. + Set strategic and tactical objectives for managed care , develop, and implement strategies, and… more
- Atrius Health (Newton, MA)
- …to Contracting . Supports Contracting Department discussions and evaluation of managed care contract terms; may propose changes in the contracts to the ... monitoring and reporting of outside medical costs. | Administers all medical cost/ managed care analytics related to capitated arrangements with insurances… more
- Cedars-Sinai (Los Angeles, CA)
- …leadership, including Pharmacy Services, Ambulatory Care Management & ISP, Contracting , and Quality. The MH Medical Director provides direct supervision ... Director oversees the full spectrum of the Collaborative Care model that currently exists to support primary ...10. Knowledge of population health practices and tools and managed care principles preferred 11. Demonstrated ability… more
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