- WTW (New York, NY)
- …Wealth and Career and Risk and Broking. The Managed Care Growth Leader is the primary client lead managing the totality of the Willis Towers Watson ... (WTW) relationship for clients within the Managed Care Industry. This individual is accountable...business while managing existing revenue and profit streams + Lead the development and execution of client account plans… more
- Hackensack Meridian Health (Edison, NJ)
- … of positive change. The **Senior Contracting Specialist** position will support the Managed Care Team during system and new entities negotiations in accordance ... the direction of the Sr. Vice President and Vice President - Managed Care . Will be responsible for addressing operational, financial and services issues and… more
- Centene Corporation (New York, NY)
- …guidance and support to clinical new hires/preceptees in navigating within a Managed Care Organization (MCO) and provides coaching and shadowing opportunities ... State RN license.** **Position Purpose:** Assesses, plans, and implements complex care management activities based on member activities to enable quality,… more
- VNS Health (Manhattan, NY)
- …coordination with, referral to and follow-up with appropriate service providers and managed care plans. Facilitates periodic case record reviews and case ... a recognized leader and innovator in patient-centered and community-focused health care . At VNS Health, you'll have the opportunity to meaningfully impact lives.… more
- VNS Health (Manhattan, NY)
- …Experience: + Minimum two years of experience in health related field required + Care management and/or managed care experience preferred + Proficiency in ... OverviewProvides telephonic clinical care management services using evidence-based practices to ensure...leader and innovator in patient-centered and community-focused health care . At VNS Health, you'll have the opportunity to… more
- Hackensack Meridian Health (Edison, NJ)
- …(BSN) or 1 year experience for non BSN HackensackUMC employees. + Knowledge of managed care principles. + Knowledge of Quality Improvement Program - New Jersey ... our mission to transform healthcare and serve as a leader of positive change. The **Transitions of Care Navigator** is a member of the healthcare team and… more
- Hackensack Meridian Health (Holmdel, NJ)
- …benefits, communication of information to insurance company, billing certifications, concurrent managed care denial appeals and retrospective medical record ... our mission to transform healthcare and serve as a leader of positive change. The ** Care Coordinator, Utilization Management** is a member of the healthcare… more
- Hackensack Meridian Health (Holmdel, NJ)
- …benefits, communication of information to insurance company, billing certifications, concurrent managed care denial appeals and retrospective medical record ... our mission to transform healthcare and serve as a leader of positive change. The ** Care Coordinator, Utilization Management** is a member of the healthcare… more
- RWJBarnabas Health (Oceanport, NJ)
- …Essential Functions + Analytical lead on modeling contract rates throughout the managed care contract negotiation process. + Assists in varying aspects of ... Category:Professional / Management Status:Full-Time Shift:Day Facility:RWJBarnabas Health Corporate Services Department: Managed Care Location: SBC Corporation, Oceanport, Oceanport,… more
- Teva Pharmaceuticals (Parsippany, NJ)
- …Formulary Compliance is responsible for supporting the development, performance and analysis of Managed Care data, post audit disputes, and PBM customer dispute ... presentation skills. **How you'll spend your day** + Review Managed Care Contracts, data, and perform analysis...audit initiatives according to Teva's rolling post audit schedule. Lead meetings, conduct analysis and work with TPA on… more
- New York University (New York, NY)
- The Managed Care Technical Assistance Center (MCTAC), an initiative funded by the Office of Mental Health, seeks a full time Program Associate to join our team. ... mental health and substance use agencies working with Medicaid, managed care , and new models of value-based...Learning Management Systems manager as needed. Contract Management: + Lead and provide oversight on the administrative management of… more
- FlexStaff (New York, NY)
- …CMO. Outcomes Management: + Have a good understanding of population health and managed care principles. + Identifies opportunities and develops programs to ... position description established by the PACE organization before working independently. Managed Care and Clinical Design: + Understand utilization management… more
- VNS Health (Manhattan, NY)
- …regulatory requirements related to all aspects of grievances and appeals for Medicare managed care organizations, Medicaid, home health care , managed ... of the following VNS Health Plans product lines - Managed Long Term Care (MLTC), Medicare Advantage...leader and innovator in patient-centered and community-focused health care . At VNS Health, you'll have the opportunity to… more
- Elevance Health (Woodbridge, NJ)
- …acute care clinical experience or case management, utilization management or managed care experience; or any combination of education and experience, which ... management process and ability to interpret and apply member Medicaid benefits, and managed care products strongly preferred. + Prior NJ Medicaid experience… more
- VNS Health (Manhattan, NY)
- …Grievance and Appeals or related area such as medical or utilization management in a Managed Care setting required + Experience in a supervisory role preferred + ... of the following VNS Health Plans product lines - Managed Long Term Care (MLTC), Medicare Advantage...leader and innovator in patient-centered and community-focused health care . At VNS Health, you'll have the opportunity to… more
- Mount Sinai Health System (New York, NY)
- …or medical economics departments or healthcare provider analytics related to managed care contracting, population management, clinical or financial decision ... **Job Description** The Lead Data Science Analyst is a senior-most analyst,...as scheduled or requested. 11. Engages with the MSHP Managed Care Contracting and Commercialization teams and… more
- TEKsystems (New York, NY)
- …medical record data abstraction requirements * An emphasis in Medicare or Medicaid/Medi-Cal managed care Skills: Hospital billing, Ambulatory, audit, managed ... , medical charts, data abstraction Top Skills Details: Hospital billing,Ambulatory,audit, managed care ,medical charts,data abstraction Additional Skills &… more
- Hackensack Meridian Health (Hackensack, NJ)
- …of Cash Receipt & posting to Finance. + Trend, analyze & report issues on Managed Care Contracts, Contract Management and other Payer related topics to be ... our mission to transform healthcare and serve as a leader of positive change. The **Supervisor, Revenue Cycle and...included in weekly Managed Care & Supervisors meeting in order… more