- 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
- RWJBarnabas Health (Oceanport, NJ)
- Senior Managed Care Analyst (Remote/Hybrid) - Oceanport, NJReq #:0000150834 Category:Professional / Management Status:Full-Time Shift:Day Facility:RWJBarnabas ... Health Corporate Services Department: Managed Care Location: SBC Corporation, Oceanport, Oceanport,...location varies given business/client need. Essential Functions + Analytical lead on modeling contract rates using EPIC throughout the… more
- VNS Health (Manhattan, NY)
- … care management services and authorizes/ coordinates services within a capitated managed care system. Communicates and collaborates with primary care ... may be required, as determined by operational needs.Clinical expertise in geriatrics, Long Term care and Managed care experience preferred CAREERS AT VNS… more
- Elevance Health (Woodbridge, NJ)
- …as a Case Manager is preferred. + Certification in the American Association of Managed Care Nurses preferred. + Broad clinical knowledge base of disease ... processes strongly preferred. + Prior managed care and case management experience preferred....is designed to advance our strategy but will also lead to personal and professional growth for our associates.… 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
- Mount Sinai Health System (New York, NY)
- …pharmacy group. 11.Obtains prior authorizations from intermediaries and payers, including managed care companies, insurance companies or others as appropriate. ... the Specialty Pharmacy Clinical Liaison, the Specialty Pharmacy Access Coordinator Lead supervises Financial Access Coordinator staff and interacts with clinical… 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
- 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
- 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
- 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 Nurse Navigator** is a member of the healthcare team… more
- Mount Sinai Health System (New York, NY)
- …Central Billing Office (CBO) and Change Departments with key aspects of Managed Care contracting support including communication, fee schedule access, ... MSO Services - MSH, Mount Sinai Hospital **Responsibilities** 1. Lead contract implementation efforts for the FPA and network...Oversee and supports the national payer contracts, acting as managed care liaison for internal and external… more
- Elevance Health (Woodbridge, NJ)
- …or related field; minimum of 5 years experience in broad-based analytical, managed care payor or provider environment; considerable experience in statistical ... **Provider Contract/Cost of Care Consultant** **We are offering a $5,000 sign-on...Works on complex enterprise-wide initiatives and acts as project lead . * Uses analytic tools to track both health… 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
- 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
- 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
- Amgen (New York, NY)
- …2 years of public or private third-party access arena or pharmaceutical industry in sales, managed care , or clinical support OR Master's degree AND 4 years of ... will participate in strategic meetings at various levels and lead their team to success. + Lead ...private third-party access arena or pharmaceutical industry in sales, managed care , or clinical support OR Bachelor's… 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 ... area such as medical or utilization management in a Managed Care setting required + Proficient verbal/written...leader and innovator in patient-centered and community-focused health care . At VNS Health, you'll have the opportunity to… more