- UTMB Health (Galveston, TX)
- Contract Admin , Managed Care - Revenue Cycle Operation Support **Galveston, Texas, United States** Business, Managerial & Finance UTMB Health Requisition ... # 2405923 **Job Summary:** The primary responsibility of the Contract Administrator - Managed Care position is to evaluate, negotiate and secure agreement to… more
- McLaren Health Care (Auburn Hills, MI)
- …escalated contractual, payor policy and operational issues through collaboration with managed care organizations and internal stakeholders. 7. Facilitates Joint ... care or related field; or an Associate degree and two (2) years' experience in managed care ; or a high school diploma or equivalent and four (4) years'… more
- Roper St. Francis (Charleston, SC)
- …Position** Manages the overall operations of managed care including managed care contract negotiations, analysis, and compliance activities in ... aligned with the strategic plan. Provides executive oversight for managed care contract performance and...related field. + Master's degree in business or healthcare administration preferred. **Work Experience** + Five years of provider… more
- RWJBarnabas Health (Elizabeth, NJ)
- …Officer + Function as primary manager and liaison with regard to our department grant/ contract (non- managed care ) business + Support compliance with grant/ ... Senior Manager, Psych Service- Admin AmbulatoryReq #:0000177187 Category:Accounting/Finance Status:Full-Time Shift:Day Facility:Trinitas Regional Medical Center… more
- MyFlorida (Tallahassee, FL)
- …analyzing results and findings and developing compliance actions as prescribed in the managed care contract (eg, corrective action plans, sanctions, ... Agency's contract managers responsible for the Medicaid managed care plan contract (s). The... administrative rules, Florida Medicaid State Plan, federal managed care waivers, and Medicaid policies. The… more
- LA Care Health Plan (Los Angeles, CA)
- …The Account Manager III is responsible for the initial on-board training of new managed care contract provider partners, and for ensuring their provider ... LAC; and providing in-service orientation meetings with providers. Responsible for monitoring managed care contracts for renewals and expirations. Acts the… more
- Mount Sinai Health System (New York, NY)
- …Agreements and Amendments, financial performance for all contracts, and facility, ancillary related contract negotiations. The Managed Care Team is at the ... work at the forefront of innovation in healthcare The Managed Care Contracting Team within MSHP is...within MSHP is responsible for the negotiation, implementation and contract compliance related to Facility Contracts for all Commercial,… more
- Community Health Systems (Franklin, TN)
- … Administration , or a related field required + 4-6 years of experience in managed care contract administration , accounts receivable, or related field ... and scheduled rate changes. + Ensures accurate interpretation and programming of managed care contract language to reflect rate structures and terms as… more
- Sharp Electronics Corporation (Fife, WA)
- **Overview** The Contract Coordinator position is responsible for the timely and accurate creation and processing of contract billing, in compliance with all ... procedures. **Responsibilities** + Ensure completeness and accuracy of maintenance contract documents including MICAS (meter automation) requirements and valid… more
- Beth Israel Lahey Health (Charlestown, MA)
- …but not limited to:** 1) Designs & performs analyses and reporting in support of managed care contract negotiations including but not limited to Hospital ... Finance. This position provides key support and analyses during rate negotiations with Managed Care Plans and performs functions related to other financial… more
- Childrens Hospital of The King's Daughters (Chesapeake, VA)
- …and Monitoring: Ensure timely and accurate implementation of managed care agreements, including fee schedules, contract terms, and performance metrics. ... + GENERAL SUMMARY + The Leader, Managed Care Contracting, is responsible for...integrated networks and clinical teams to ensure alignment between contract requirements and clinical care delivery models.… more
- Hackensack Meridian Health (Edison, NJ)
- …leader of positive change. The **Senior Contracting Specialist** position will support the Managed Care Team during system and new entities negotiations in ... under the direction of the Sr. Vice President and Vice President - Managed Care . Will be responsible for addressing operational, financial and services… more
- Sanofi Group (Bridgewater, NJ)
- … Operations **Location** : Bridgewater, NJ **About the Job** The Managed Care Specialist is responsible for contract management for various markets including ... ECP (Electronic Claims Processor) and Revenue Manager (Model N administration system). This position will analyze and pay rebates...will work in close cooperation with Managed Care Operations colleagues and counterparts in Contract … more
- Cedars-Sinai (CA)
- …service the network's membership. + Monitors and Tracks all other aspects of Managed Care , quality & efficiency measures, Star ratings, access, physician network ... user or client acceptance. + Well versed within the various components that comprise Managed Care and its key concepts including but not limited to eligibility,… more
- Cedars-Sinai (Beverly Hills, CA)
- …implementation financial initiatives; assisting in the interpretation of policies/procedures/practices. Managed Care Reporting: + Prepare reports and ... modeling and forecasting to assess the impact of proposed contract changes and new initiatives. + Monitor and evaluate...identifying trends, variances, and areas for improvement. + Analyze managed care contracts for compliance and financial… more
- Children's Hospital Los Angeles (Glendale, CA)
- …payor models, as well as negotiation, communication, implementation and oversight of managed care contracting and collaboration with operative partners. This ... including but not limited to fee-for-service (FFS) and Medi-Cal Managed Care payment arrangements, as well as...The ability to analyze and explain complex concepts and contract terms to a broad audience that includes physicians… more
- CommonSpirit Health (Englewood, CO)
- …is a remote position. Seeking a strong manager of technical healthcare teams for Managed Care .** **Job Summary / Purpose** The System Manager, Data Engineering ... Initiatives (CHI) and Dignity Health. With more than 700 care sites across the US from clinics and hospitals...in healthcare **Strongly Preferred Experience** + Experience in payer contract analysis and payer process preferred + Experience with… more
- Fresenius Medical Center (Franklin, TN)
- …and administration of contracting and pricing procedures. This includes contract terms and conditions, products and prices for various market segments and ... to, supporting analysis, documentation and reports + to support negotiations of contract terms and department administration . + Maintains complete, accurate, and… more
- Queen's Health System (Honolulu, HI)
- …EDUCATION/CERTIFICATION AND LICENSURE: * Bachelor's degree in Business, Finance, or Health Care Administration ; OR, four (4) years experience in healthcare ... to make recommendations to maximize cost and quality of care . * Serves as a liaison with third party...provider contract coordination and administration may be substituted… more
- US Tech Solutions (Columbia, SC)
- …regarding benefits and clinical criteria by applying clinical expertise, administrative policies, and established clinical criteria to service requests or ... clinical information to support and determine medical necessity criteria and contract benefits. Provides telephonic support for members with chronic conditions, high… more