- 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)
- …serve as a leader of positive change. The **Senior Contracting Specialist Managed Care ** will develop and negotiate owned and affiliated partner companies' ... language parameters. **Candidates should be experienced in all aspects of Managed Care Contracting including a full and comprehensive knowledge of contractual… more
- VNS Health (Manhattan, NY)
- … care management services and authorizes/ coordinates services within a capitated managed care system. Communicates and collaborates with primary care ... are action-oriented, time-specific and cost effective. + Implements specific care management activities and or interventions that lead...operational needs. + Clinical expertise in geriatrics, Long Term care and Managed care experience… more
- Elevance Health (New York, NY)
- …or related field and a minimum of 3 years experience in broad-based analytical, managed care payor or provider environment as well as experience in statistical ... **Anticipated End Date:** 2024-09-27 **Position Title:** Provider Contract/Cost of Care Analyst Senior-Analytics **Job Description:** **Provider Contract/Cost of … 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
- 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
- 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 Management, Care Coordinator, Utilization Management** is a… 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 (Hackensack, 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 (Hackensack, 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 **Case Management Care... leader of positive change. The **Case Management Care Coordinator, Utilization Management** is a member of the… more
- Hackensack Meridian Health (Hackensack, 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 Case Management Care... leader of positive change. The Case Management Care Coordinator, Utilization Management is a member of the… more
- Martin's Point Health Care (New York, NY)
- …medical record. + Proficiency of medical terminology. + Understanding of the managed care environment. + Demonstrated understanding of community services and ... Join Martin's Point Health Care - an innovative, not-for-profit health care...contributor, provider and leadership roles. Please consult with your leader to discuss additional competencies that are relevant to… 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
- Comunilife (New York, NY)
- …management documentation, external networking/communication with contracted entities (hospitals and Managed Care Organizations). The Senior Program Director ... Program Director-Respite Care Job Details Job Location New York, NY...Job Category Management Description The Senior Program Director will lead the overall operation of our medical Respite service… more
- The 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, ... and resolved. 6. Oversee and supports the national payer contracts, acting as managed care liaison for internal and external constituents in all facility… more
- The Mount Sinai Health System (New York, NY)
- …and contract compliance activities with the goal of optimizing and improving managed care reimbursement through efficient clinical delivery and aligned clinical ... economical and effective healthcare + Completes in a timely manner all managed care applications, credentialing, and re-credentialing requests from the corporate… more
- The Mount Sinai Health System (New York, NY)
- …setting, and effective performance measurement. The Senior Director - Actuary will be a leader in the Managed Care and Population Health Analytics ... in a financially sustainable manner. **RESPONSIBILITIES** * Partner with stakeholders from Managed Care and/or Population Health departments who will look to… more
- The Mount Sinai Health System (New York, NY)
- …management and others as scheduled or requested. 11. Engages with the MSHP Managed Care Contracting and Commercialization teams and interface with key leaders ... **JOB DESCRIPTION** The Lead Data Science Analyst is a senior-most analyst,...medical economics departments or healthcare provider analytics related to managed care contracting, population management, clinical or… 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