- 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
- 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
- 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
- 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
- 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
- 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
- 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)
- …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
- CenterLight Health System (Ridgewood, NY)
- …CMO. Outcomes Management: + Have a good understanding of population health and managed care principles. + Identifies opportunities and develops programs to ... position description established by the PACE organization before working independently. Managed Care and Clinical Design: + Understand utilization management… 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
- Mount Sinai Health System (New York, NY)
- …or medical economics departments or healthcare provider analytics related to managed care contracting, population management, clinical or financial decision ... **Job Description** The Lead Data Science Analyst is a senior-most analyst,...as scheduled or requested. 11. Engages with the MSHP Managed Care Contracting and Commercialization teams and… more
- Molina Healthcare (New York, NY)
- …of supervisory responsibility. + Health insurance experience required. + Significant experience in managed care , with strong knowledge of managed care ... + History of progressively increasing responsibility in financial management in a managed care environment. + Ability to coordinate cross functional projects,… more
- FlexStaff (New York, NY)
- …they meet professional standards. - Understand and apply principles of population health and managed care . - Identify opportunities to improve quality of care ... population in our communities. If you are an experienced leader in medical care with a passion...staff supervision experience; experience in value-based organizations, advanced primary care , or managed care preferred;… more
- VNS Health (Manhattan, NY)
- …with HIV patients with a focus on public health) required + Strong knowledge of health care delivery systems, managed care , and patient care required + ... health care regulations related to Medicare, Medicaid, managed care , and long term care...leader and innovator in patient-centered and community-focused health care . At VNS Health, you'll have the opportunity to… more