- Collabera (Newark, NJ)
- …or an active New Jersey Registered Nurse License. Required Skills: Knowledge of managed care principles and medical terminology. Proficiency in PC's and related ... on programs and audit standards. Serve as an in-house representative and project lead for state audits. Analyze audit findings and produce various reports as… more
- Fidelity TalentSource LLC (Jersey City, NJ)
- …systems and shell scriptingExperience with Amazon Web Services (AWS), having managed services and applications in a large AWS cross-account environment using ... Fidelity Investments. Our global, diverse team of hundreds of forward-thinking professionals lead with agility and creativity to build solutions that bridge the gap… more
- 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
- Catholic Health Services (Melville, NY)
- …contract updates to understand impacts to reimbursement from federal, state, and managed care payers. Corrects transactions and transfers balances to responsible ... Our health system has over 16,000 employees, six acute care hospitals, three nursing homes, a home health service,...carrier or revenue cycle system issues to the Team Lead and/or Supervisor. Participates in projects and audits as… more
- VNS Health (Manhattan, NY)
- … care management services and authorizes/ coordinates services within a capitated managed care system. Communicates and collaborates with primary care ... are action-oriented, time-specific and cost effective. * Implements specific care management activities and or interventions that lead...by operational needs. Clinical expertise in geriatrics, Long Term care and Managed care experience… more
- VNS Health (Manhattan, NY)
- … care management services and authorizes/ coordinates services within a capitated managed care system. Communicates and collaborates with primary care ... are action-oriented, time-specific and cost effective. + Implements specific care management activities and or interventions that lead...operational needs. + Clinical expertise in geriatrics, Long Term care and Managed care experience… more
- VNS Health (Manhattan, NY)
- …Managed Long Term Care health plans, preferred + Experience in a managed care environment, preferred + Experience in excel, preferred CAREERS AT VNS ... team to achieve excellence in the daily operations of care coordination with a focus on quality, compliance, and...leader and innovator in patient-centered and community-focused health care . At VNS Health, you'll have the opportunity to… 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)
- …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 Management, Care Coordinator, Utilization Management** is a… 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 Navigator** is a member of the healthcare team and… 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 Management, Care Coordinator, Utilization Management** is a… more
- Hackensack Meridian Health (Hackensack, 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 (Hackensack, 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 **Case Management Care... leader of positive change. The **Case Management Care Coordinator, Utilization Management** is a member of the… more
- Hackensack Meridian Health (Hackensack, 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 Case Management Care... leader of positive change. The Case Management Care Coordinator, Utilization Management is a member of the… more
- RWJBarnabas Health (Oceanport, NJ)
- …Essential Functions + Analytical lead on modeling contract rates throughout the managed care contract negotiation process. + Assists in varying aspects of ... Category:Professional / Management Status:Full-Time Shift:Day Facility:RWJBarnabas Health Corporate Services Department: Managed Care Location: SBC Corporation, Oceanport, Oceanport,… more
- Martin's Point Health Care (New York, NY)
- …medical record. + Proficiency of medical terminology. + Understanding of the managed care environment. + Demonstrated understanding of community services and ... Join Martin's Point Health Care - an innovative, not-for-profit health care...contributor, provider and leadership roles. Please consult with your leader to discuss additional competencies that are relevant to… more
- Comunilife (New York, NY)
- …management documentation, external networking/communication with contracted entities (hospitals and Managed Care Organizations). The Senior Program Director ... Program Director-Respite Care Job Details Job Location New York, NY...Job Category Management Description The Senior Program Director will lead the overall operation of our medical Respite service… more
- The 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, ... and resolved. 6. Oversee and supports the national payer contracts, acting as managed care liaison for internal and external constituents in all facility… more
