- 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)
- …** at Hackensack Meridian _Health_ includes: + **Contract Negotiation & Network Management:** + Lead all managed care contract negotiations for HMH and its ... our mission to transform healthcare and serve as a leader of positive change. The **Senior Vice President (SVP)...+ Lead the development and execution of managed care contracting policies and strategies. Monitor… more
- Hackensack Meridian Health (Edison, NJ)
- …applicable. + Write Care Plans in EPIC Healthy Planet for high-risk patients being care managed . + Other duties and/or projects as assigned. + Adheres to HMH ... our mission to transform healthcare and serve as a leader of positive change. The ** Care Coordinator...Registered Nursing Program. + Minimum 2-3 years experience in managed care or health education/coaching is preferred.… 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
- Hackensack Meridian Health (Edison, NJ)
- …knowledge and understanding of the different types of commercial carriers and managed care organizations, + effectively communicating specifics to persons ... our mission to transform healthcare and serve as a leader of positive change. **Responsibilities** A day in the...involved on all levels. Utilizes current managed care contract matrix, different insurancesystems 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 ... 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
- Hackensack Meridian Health (Edison, NJ)
- …Knowledge, Skills and Abilities Required** : + Bachelors degree. + Knowledge of managed care principles. + Knowledge of Quality Improvement Program - New ... 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 (Neptune, 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
- Community Health Action of Staten Island (Staten Island, NY)
- …in lieu of some years of experience listed above. + Advanced knowledge of Medicaid/ Managed care billing is a plus. + Advanced computer skill, specifically ... color, and the LGBTQ community. POSITION SUMMARY: The Director of Care Management is the lead manager and administrator for the Medicaid funded Health Home… 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
- Mount Sinai Health System (New York, NY)
- …clinical, contracting, finance, IT, analytics, operations, and product development expertise. The Managed Care Contracting Team within MSHP is responsible for ... Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as...Issues: * Proactively escalate issues to Directors that could lead to significant legal ramifications or require intervention by… 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
- Mount Sinai Health System (New York, NY)
- …+ Oversee the cost model development and calculations at each facility + Work with managed care , finance and reimbursement staff on an ongoing basis to maintain ... Vice President Financial Planning & Analysis** This role will lead this integral finance team through an important system...the Health System in the evaluation and negotiations of managed care contracts and operations in conjunction… 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