- 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
- VNS Health (Manhattan, NY)
- …+ Doctorate in Pharmacy (PharmD) required Work Experience: + Minimum of five years of Managed Care Pharmacy experience required + Experience in a managed ... 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
- 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 ... on workplace flexibility. **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
- Graham Windham (Bronx, NY)
- …necessary documents for monthly care management billing to Health Home/ Managed Care Organization. Position Qualifications: + Bachelor's degree in health ... Health Homes Care Manager, Bronx Job Details Job Location 1946...to create and implement innovative strategies so everyone can lead healthy, joyful, and successful lives. Principal Objective/Role Overview:… more
- City of New York (New York, NY)
- …State agencies (eg, SDOH, SOMH, OASAS, OPWDD), community health, mental health, and managed care organizations around child mental health services at DHS. ... of succeeding in permanent housing and independent living, improving access to care and health outcomes for low-income and vulnerable populations. The Office brings… more
- City of New York (New York, NY)
- …impact of the 2022-2027 NYS Medicaid 1115 Waiver on public health outcomes. - Lead managed care collaboration initiatives for COVID-19 management and ... Local, State, and Federal legislation, policies, and programming. Medicaid Managed Care and Medicare Advantage payment and...78], Local Law 52 Local Law 163, etc.). - Lead efforts to maximize impact of NYS AHEAD model.… more
- NYU Rory Meyers College of Nursing (New York, NY)
- …also be responsible for collaboration and communication between commercial insurance and managed care companies and key internal stakeholder within NYU ... and the implementation and management of commercial insurance and managed care contracts. Qualifications Required Education:Bachelors DegreePreferred… 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 + ... activities for staff handling grievances and appeals across our 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
- 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
- FlexStaff (Bayside, NY)
- …years in care /case management, disease management, or related fields (preferably within managed care , home care , or community health organizations). - At ... processes. As the Director of Clinical Intake, you will lead and manage all clinical activities related to the...2+ years of experience in Managed Long-Term Care (MLTC) or Managed Care … more
- Catholic Health Services (Melville, NY)
- …and quarterly reports reflecting accurate departmental data Works with Revenue Cycle and Managed Care teams to identify and resolve issues related to timely ... and management; contributes to completion of project status reports. Lead meetings with staff and/or leadership to assist in...resolution of managed care cases Ability to work on… more
- Molina Healthcare (New York, NY)
- …and experience **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:** * 8+ years of Medicaid managed care experience or in an equivalent related field * Ability ... with Medicaid Proposals and/or business development and requires demonstrated Medicaid managed care experience comprised of technical operational, sales, growth,… more
- VNS Health (Manhattan, NY)
- …Experience: Minimum of three years of progressive experience in consulting, healthcare, managed care , quality, or a related disciple required Advanced project ... Minimum of one year progressive experience in consulting, healthcare, managed care , quality, or a related discipline...leader and innovator in patient-centered and community-focused health care . At VNS Health, you'll have the opportunity to… more
- CenterLight Health System (Flushing, NY)
- …may authorize a range and number of community-based services. + Implements specific care management activities and interventions that lead to accomplishing the ... experience, diagnostic & treatment clinic preferred. Customer Service experience required. Managed long-term care insurance experience beneficial. Minimum of… more
- Centene Corporation (New York, NY)
- …including "metal" products offered through the New York State of Health (NYSOH), Medicaid Managed Care , Child Health Plus, Medicare, MLTC, FIDA and HARP. Ability ... the Sales Force CRM as an activity tracking and lead /referral tracking tool, to manage appointments and follow up,...GED, required. 2 to 5 years prior experience in managed care , sales, customer service or related… more
- Molina Healthcare (New York, NY)
- …guidelines. + Experience in Utilization/Quality Program management + HMO/ Managed care experience **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** ... and action plan, which includes strategies that ensure a high quality of patient care , ensuring that patients receive the most appropriate care at the most… more
- Mount Sinai Health System (New York, NY)
- …preferred) ? + ASHP Accredited PGY-2 Pharmacy Practice Residency preferred (Ambulatory or Managed Care ) + Minimum of five years health-system or managed ... leadership. The Clinical Pharmacy Manager will have direct patient care responsibilities aligned with care delivery goals...at the practices assigned to this role. Manager will lead the design, implementation and evaluation of all related… more
- CenterLight Health System (Flushing, NY)
- …health management, utilization review, quality assurance or discharge planning (preferably within a managed care , home care or community health organization) ... + Minimum two (2+) years of experience in MLTC/ Managed Care with preparation of Uniform Assessment System of New York (UAS-NY) + Proficiency utilizing and… more