- Zurich NA (Trenton, NJ)
- Managed Care , Claims Vendor Management Sr Specialist 118916 Zurich North America is seeking a Managed Care , Claims Vendor Management ... United States. **About the Role** As a Senior Specialist in Managed Care and Claims Vendor Management, you will play a key role in administering… more
- VNS Health (Manhattan, NY)
- …senior management on highly visible projects to understand business needs and challenges of managed care payors and to develop innovative solutions to meet those ... and to develop, design, plan, and deliver information systems solutions to meet managed care payor needs. + Functions as lead Business Systems Analyst… more
- Humana (Trenton, NJ)
- …7+ years of related compliance and/or special investigation experience in managed care or CMS. + Prior health insurance claims experience + Demonstrated ... Attend federal CMS and state fraud meetings with other managed care organizations, as well as state...exciting interviewing technology provided by Modern Hire, a third-party vendor . This technology provides our team of recruiters and… more
- HealthEdge Software Inc (Trenton, NJ)
- …Practical understanding of the healthcare system with regards to Medicare, Medicaid, managed care , and commercial payment methodologies, payment integrity, and ... and maintenance of provider rate and/or claim editing provisions in a claims adjudication system and/or third-party vendor application. + Working knowledge… more
- Takeda Pharmaceuticals (Trenton, NJ)
- … Vendor Management + Oversight and accountability for labeling activities managed by external vendor (s) for assigned products, ensuring seamless coordination, ... labeling requirements to be provided to patients and Health Care Providers while minimizing the risk of write-offs. +...to ensure consistency with the overall product strategy, product claims and information in the CCDS and to ensure… more
- City of New York (New York, NY)
- …of public and commercial payors at the federal and state levels, and the evolution of managed care - Value-based care and Alternative Payment Models. - Price ... All-Payer Claims Databases, and other employer-led strategies promote high-value care - Civil rights and non-discrimination in healthcare - Medicaid policy and… more
- City of New York (New York, NY)
- …commercial payors at the federal and state levels, and the evolution of managed care . The regulation and financing of community-based organizations (CBO's) at ... Value-based care and Alternative Payment Models. Price transparency, All-Payer Claims Databases, and other employer-led strategies promote high-value care .… more
- VNS Health (Manhattan, NY)
- …Minimum of six years of progressively responsible actuarial experience in a Health Plan/ Managed Care organization or similar environment at least some of which ... programs + Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care + Generous tuition reimbursement for qualifying degrees + Opportunities for… more