- Stryker (Mahwah, NJ)
- **What you will do:** As the Senior Manager of Reimbursement and Market Access (RMA) for Interventional Spine (IVS) you will lead payer-based initiatives to ... attending marketing/sales meetings. + Develop and maintain relationships with Medicare contractors and commercial payors (including Medical Directors, Policy… more
- Hackensack Meridian Health (Hackensack, NJ)
- …Clarifying ambiguous or conflicting documentation iv. Target DRGs Reviews v. Use of case manager as a resource 4. Uses guidelines to evaluate patient status based on ... length of stay, level of care requirements and Medicare regulations, and Major Complications or Comorbidities (MCC) / Complications or Comorbidities 5. (CC)… more
- CVS Health (New York, NY)
- …in new and exciting ways every day. Aetna is recruiting for an AVP, General Manager who has Medicare market specific P&L accountability for the IVL/DSNP products ... Medicare plans within the Market. + Direction of senior leaders of specific functional areas as assigned. Functional...for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed… more
- Teva Pharmaceuticals (Parsippany, NJ)
- Senior Manager Patient Services Hub Operations Date: Feb 20, 2025 Location: Parsippany, United States, New Jersey, 07054 Company: Teva Pharmaceuticals Job Id: ... people to make a difference with. **The opportunity** The Senior Manager , Patient Services Hub Operations seeks...among Insurers, PBMs, and Specialty Pharmacies including Medicaid and Medicare . + Ability to work with senior … more
- Centene Corporation (New York, NY)
- …enhance member and provider experience, while driving financial performance of the program . Works with Market and Shared Services stakeholders to achieve Market and ... $1 billion, respectively. + Executively manages APP with more than 165,000 Medicare members and annualized revenue totaling $2.2+ billion, representing 15%+ of the… more
- VNS Health (Manhattan, NY)
- …CFEEC scheduled dates and outcomes as needed. * Offers assignment of Medicare assistance as needed. * Responds to inquiries regarding pre-enrollment issues, ... eligibility and program information to ensure service satisfaction. Works with our...for new enrollees start of care authorizations and care manager assignment. * Assists in the monitoring and updating… more
- Gentiva (Livingston, NJ)
- …Reimbursement** You will report directly to the Executive Director, Administrator, or Senior Patient Care Manager . You will be responsible for maintaining ... every day. **Overview** We're looking for a **Patient Care Manager ** to join our team. **RN Clinical Manager...Time Employee Benefits:** + **Medical, Dental, Vision** + **Wellness Program and Resources** + **401k match** + **PTO** +… more
- Molina Healthcare (New York, NY)
- …the severity of illness and the site of service. This position will support our Senior Whole Health business. Senior Whole Health by Molina is a Managed ... or disabled people who are eligible for Medicaid and Medicare . We are looking for Case Managers with a...Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) Program OR Bachelor's or master's degree in a social… more
- Molina Healthcare (Yonkers, NY)
- **Job Description** **Job Summary** The Provider Engagement Manager implements Health Plan provider engagement strategy to achieve positive quality and risk ... meetings and action plans. Addresses practice environment challenges to achieve program goals and improve health outcomes. Tracks engagement activities using… more
- Hackensack Meridian Health (Hackensack, NJ)
- **Overview** The Senior Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the integrity ... documentation e. Target DRGs Reviews f. Use of case manager as a resource + Uses guidelines to evaluate...on length of stay, level of care requirements and Medicare regulations, and Major Complications or Comorbidities (MCC) /… more
- Mount Sinai Health System (New York, NY)
- …risk adjustment for all populations served, especially our patients covered under a Medicare arrangement (MSSP or MA). The MD will report to Vice President, Clinical ... Health Practice Optimization Lead (working collaboratively with a Population Health Manager (PHM)) for 6-10 high priority primary care/multispecialty practices. *… more
- VNS Health (Manhattan, NY)
- …+ Completes, reports including Key Volume Drivers, schedule of Accounts Receivable, Program Highlight (Actual vs. Budget) and A/R monthly Aging report. + Works ... with Manager to financially plan for new programs by addressing...references in year-end audit. + Provides analytical support to Senior Financial Management and other Finance staff, as needed.… more