- Commonwealth Care Alliance (Boston, MA)
- 011230 CA-Provider Engagement & Performance **Position Summary** The Program Manager , in collaboration with the Sr Director of Delegation Partnerships and ... contract performance metrics + Experience with Medicare Advantage, Medicaid ; and dually eligible populations **Desired Experience** + Experience managing or… more
- Pairtu (San Francisco, CA)
- …have the operational backbone to deliver consistently. We're looking for a senior , hands-on operator who can work across credentialing, payer contracting, provider ... need structure and predictability or 'need to be a manager ' this isn't for you. The upside? You'll level...credentialing, payer enrollment, and ongoing compliance. - Keep every contract , license, and NPI file audit-ready. **2. Be the… more
- Serco (Herndon, VA)
- **Position Description** Serco is seekinga self-starter ** Senior Manager Compliance** to join our talented and fast-paced team supporting millions of people ... email to: careers@serco-na.com . Click here to apply now (https://careers-sercous.icims.com/jobs/72095/ sr .- manager -compliance/job?mode=apply&apply=yes&in\_iframe=1&hashed=-1834477830) **New to Serco?** Join our Talent… more
- Covenant Health Inc. (Crossville, TN)
- Overview Senior Risk Manager and Regulatory Specialist, Quality Managment Full Time, 80 Hours Per Pay Period, Day Shifts Cumberland Medical Center Overview: ... a family-oriented environment focused on exceptional patient care. Position Summary: The Sr . Risk Manager and Regulatory Specialist position is responsible for… more
- Abbott (Livermore, CA)
- …team responsible for following: payor contract negotiation, payor contract implementation, payor contract monitoring, Medicare/ Medicaid enrollment, ... multiple) of the following fields: DME, IDTF, hospital administration, Medicare, Medicaid , commercial payors + Experience leading regulatory audits, either as… more
- Health Care Service Corporation (Richardson, TX)
- …responsible for market and partner direct relationship development, critical contract negotiations, establishing fee-for-service and value based contracts that ... implications thereof; documenting and conducting analysis of current and proposed contract arrangements and its impact on HealthSpring strategy and managing its… more
- Covenant Health Inc. (Knoxville, TN)
- …the baseline and periodic compliance audits and compliance programs as deemed appropriate by manager . + Works with contract management personnel in the review of ... Performs other duties as needed. Reports to the Revenue Integrity Manager . Recruiter: Suzie McGuinn || ###@covhlth.com Responsibilities Integrity + Identifies and… more
- Elevance Health (Richmond, VA)
- …face-to-face onboarding and skill development._ The **Medical Management Clinician Sr ** is responsible for ensuring appropriate, consistent administration of plan ... with department guidelines and consistent with the members eligibility, benefits and contract . + May process a medical necessity denial determination made by a… more
- CVS Health (Annapolis, MD)
- …and/or complex contracting activities, including the collection of all required contract and credentialing documents, and obtains the necessary approval of ... that may include, but are not limited to, database management and contract coordination. + Provides ongoing recommendations to leadership to guide decision-making… more
- IQVIA (New Providence, NJ)
- **Job Overview** During project assignments, works closely with Principal/Engagement Manager , serving as a key contributor to client engagements, with a focus on ... within one or more specific functional or technical workstreams (eg, Medicaid , Master Data Management, Chargebacks, Government Pricing, Testing, Managed Care… more
- CVS Health (Lansing, MI)
- …and ancillaries in accordance with company standards. As a Senior Network Manager you will manage contract performance and support the development and ... Summary** In this individual contributor role the Network Management Senior Manager will negotiate, execute, and conduct...implementation of strategic, value-based contract relationships, maintain and enhance provider networks to meet… more
- Mount Sinai Health System (New York, NY)
- …Facility and Ancillary Contracts across the Mount Sinai Health System. MSHP seeks a ** Senior Contract Manager Analyst** will play a critical role in ... Opportunity for advancement within MSHP team + Opportunity to work directly with senior leaders from across the Mount Sinai Health System and external organizations… more
- CVS Health (Downers Grove, IL)
- …we do it all with heart, each and every day. **Position Summary:** The Sr . Manager is an experienced/career level compliance position that applies compliance, ... organization environment with a current focus on integrated special needs plans. The Sr . Manager Compliance maintains productive relationships and open lines of… more
- Providence (Santa Monica, CA)
- **Description** Senior Contract Sourcing Program Manager at Providence Saint John's Health Center in Santa Monica, CA. This position is Full time and will ... 5-star rating for quality, safe care from the Centers of Medicare and Medicaid Services (CMS). Purchased Services and Physician Contracting provides contract … more
- Ascendis Pharma (Princeton, NJ)
- …and develop their skills. Position Summary: We are seeking a highly motivated Senior Manager to support our Contracting Operations function within the Market ... This individual will be responsible for the day-to-day management of contract operations activities across pharmaceutical pricing, contracting, and rebate agreements… more
- Walmart (Bentonville, AR)
- **Position Summary ** As Senior Manager , Payer Programs (Rx Clinical Services), you will drive Walmart's payer strategy by building strategic partnerships with ... payer relationships, from business development and payer pitches through contract negotiations and long-term account management, ensuring partnership success and… more
- Abbott (Abbott Park, IL)
- …the way patients and professionals measure, track and analyze glucose levels. As a Senior Manager Market Access Pricing and Analytics, you will be responsible ... strategies across all ADC brands and customer channels, including Managed Care, Medicaid , Medicare, Retail, and Point of Care (POC). The position supports the… more
- Public Consulting Group (St. Paul, MN)
- …posted timely. (20%) **Organizational Relationships** **Reports directly to the ASO Project Manager / Sr . Director of Operations** **Key Qualifications and ... across the public sector. To learn more, visit www.publicconsultinggroup.com . The Contract Support and RCM Analyst will support both the contractual administrative… more
- Elevance Health (San Juan, PR)
- **Associate General Counsel Senior - Commercial Transactions** **Location: #350 Carlos Chardon Avenue, Suite 805, Puerto Rico.** This role requires associates to be ... LLC is a company that provides Medicare Advantage and Medicaid plans in Puerto Rico. Currently, MMM Holdings, LLC...more than 118 million people. The **Associate General Counsel Senior - Commercial Transactions is** responsible for developing and… more
- Mount Sinai Health System (New York, NY)
- …all financial terms. + Procure and upload all financial data into Experian Contract Manager Tool to determine financial performance. + Model Payer Proposals ... within MSHP team + Opportunity to work directly with senior leaders from across the Mount Sinai Health System...in Experian Contract Manager Tool. + Reconcile budgeted revenue… more
