- 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
- Amneal Pharmaceuticals (Bridgewater, NJ)
- Description: The primary responsibilities of the Manager, Managed Care Rebates, are to provide management, mentoring, and training analysts as needed and ensure ... role will be responsible for leading and supporting the Managed Care claims processing, contract maintenance, formulary...active role in the closing process. The Manager will lead , manage, develop and motivate individuals to collectively build… 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
- 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 (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 **Navigator, Tranistions of Care ** is a member of the healthcare team and is… 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
- 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 ... EST; Monday-Friday.** **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
- 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 (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
- 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