- 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
- 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
- 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
- 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
- New York University (New York, NY)
- The Managed Care Technical Assistance Center (MCTAC), an initiative funded by the Office of Mental Health, seeks a full time Program Associate to join our team. ... mental health and substance use agencies working with Medicaid, managed care , and new models of value-based...Learning Management Systems manager as needed. Contract Management: + Lead and provide oversight on the administrative management of… 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
- FlexStaff (New York, 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)
- …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
- 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
- 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
- TEKsystems (New York, NY)
- …medical record data abstraction requirements * An emphasis in Medicare or Medicaid/Medi-Cal managed care Skills: Hospital billing, Ambulatory, audit, managed ... , medical charts, data abstraction Top Skills Details: Hospital billing,Ambulatory,audit, managed care ,medical charts,data abstraction Additional Skills &… more
- VNS Health (Manhattan, NY)
- …of eight (8) years of progressive leadership in quality improvement with specific managed care experience with (5) years of progressive managerial experience in ... healthcare required + Extensive knowledge of managed care regulations and quality standards and...leader and innovator in patient-centered and community-focused health care . At VNS Health, you'll have the opportunity to… more
- Centene Corporation (Westbury, NY)
- …including "metal" products offered through the New York State of Health (NYSOH), Medicaid Managed Care , Child Health Plus, Medicare, MLTC, FIDA and HARP. Ability ... the Sales Force CRM as an activity tracking and lead /referral tracking tool, to manage appointments and follow up,...GED, required. 2 to 5 years prior experience in managed care , sales, customer service or related… more
- Elevance Health (New Hyde Park, NY)
- …the applicable medical policy and industry standards accurately interpreting benefits and managed care products and steering members to appropriate providers, ... management or care management experience in a managed care setting is highly preferred. +...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
- VNS Health (Manhattan, NY)
- …objectives associated with the strategic position of health plan-sponsored Medicare and Medicaid managed care products, with regard to quality of care ... care setting required + Experience in a Managed Care or Homecare organization preferred +...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)
- …two years of experience working with customers in customer service, medical or managed care environment required, required + Excellent verbal and written ... Knowledgeable on how to navigate all aspects of medical care and managed care system,...leader and innovator in patient-centered and community-focused health care . At VNS Health, you'll have the opportunity to… more
- Pfizer (New York, NY)
- …marketplace + Experience in account management or account management support functions + Managed Care or Customer Strategy experience and in depth understanding ... Pfizer US Oncology Biosimilars portfolio and select Branded IV assets across managed markets (Biosims only), hospital systems, GPO customer segments and key… more
- Guidehouse (New York, NY)
- …are not limited to medical and pharmacy claims (open and closed), formulary and managed care data, and EMR data. + Experience across multiple third-party data ... sizing/ segmentation, provider profiling/targeting, provider affiliation mapping, epidemiology studies, managed care analytics, pull-through modeling / program… more
- Ascendis Pharma (New York, NY)
- …barriers for patients and providers by providing appropriate and accurate managed care coverage and reimbursement criteria regarding products within ... in their assigned territory + Demonstrate extensive knowledge of individual managed care account's geographic presence/influence, payor mix, product coverage… more