• Novo Nordisk Inc. (Yorktown Heights, NY)
    …elements in the market to identify and leverage business opportunities Analyze impact of managed care in the territory and its effect on prescribing decisions, ... relationships with healthcare providers, positioning Novo Nordisk as a leader in obesity care , understanding the local...align to audience needs Leverage understanding of impact of managed care in the territory and how… more
    HireLifeScience (12/07/24)
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  • Managed Care Leader

    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
    WTW (01/24/25)
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  • Director, Ethics & Compliance Advisor, US…

    Gilead Sciences, Inc. (Parsippany, NJ)
    …understanding of market access functions such as payer contracting, reimbursement, pricing, and managed care . + Invest time and effort in building strong ... direct impact. We believe every employee deserves a great leader . People Leaders are the cornerstone to the employee...unmet medical needs and improve life by advancing the care of patients with life-threatening diseases. **Director, Ethics &… more
    Gilead Sciences, Inc. (01/11/25)
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  • Social Work Care Coordinator (mostly…

    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
    VNS Health (01/23/25)
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  • Pharma Field Sales - Obesity Care

    Novo Nordisk (Yorktown Heights, NY)
    …in the market to identify and leverage business opportunities + Analyze impact of managed care in the territory and its effect on prescribing decisions, and ... relationships with healthcare providers, positioning Novo Nordisk as a leader in obesity care , understanding the local...to audience needs + Leverage understanding of impact of managed care in the territory and how… more
    Novo Nordisk (12/07/24)
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  • Specialty Pharmacy Financial Access Coordinator,…

    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
    Mount Sinai Health System (12/18/24)
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  • Director, Corporate Accounts

    Mitsubishi Chemical Group (Jersey City, NJ)
    … that is responsible for oversight, leadership, management, and tactical execution of the Managed Care team. This person will focus and direct the strategy for ... our lead ALS therapy and future products in the United...future products. + Set strategic and tactical objectives for managed care , develop, and implement strategies, and… more
    Mitsubishi Chemical Group (11/12/24)
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  • Clinical Care Manager (RN) -- CMO

    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 (01/14/25)
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  • Care Manager

    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 (11/22/24)
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  • Health Homes Care Manager

    Graham Windham (Bronx, NY)
    …necessary documents for monthly care management billing to Health Home/ Managed Care Organization. Position Qualifications: + Bachelor's degree in health ... Health Homes Care Manager, Bronx Job Details Job Location 1946...to create and implement innovative strategies so everyone can lead healthy, joyful, and successful lives. Principal Objective/Role Overview:… more
    Graham Windham (12/17/24)
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  • Manager, Contract Support - Mount Sinai Health…

    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
    Mount Sinai Health System (01/04/25)
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  • Family Care Coordination Assistant Director

    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 (12/26/24)
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  • Healthcare Payment & Financing Innovation Senior…

    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
    City of New York (12/08/24)
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  • Director of Dental Insurance Strategy

    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
    NYU Rory Meyers College of Nursing (01/08/25)
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  • Specialist, Grievance and Appeals

    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
    VNS Health (01/23/25)
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  • Regional Medical Director

    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
    CenterLight Health System (11/30/24)
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  • Manager, Grievance and Appeals, RN

    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
    VNS Health (12/04/24)
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  • Lead Data Science Analyst

    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
    Mount Sinai Health System (11/12/24)
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  • Revenue Cycle Analyst

    Hackensack Meridian Health (Hackensack, NJ)
    …are not limited to Patient Accounting, Case Management, Health Information, Clinical, Training, Managed Care and IT. Duties performed are at multiple sites ... our mission to transform healthcare and serve as a leader of positive change. The **Revenue Cycle Analyst** provides...payment discrepancies which will be used as escalation to Managed Care , the payer, or IT. Monitors… more
    Hackensack Meridian Health (01/24/25)
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  • AVP, Health Plan Finance (Wisconsin) - REMOTE

    Molina Healthcare (Yonkers, 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
    Molina Healthcare (01/23/25)
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