- 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
- Hackensack Meridian Health (Edison, NJ)
- … of positive change. The **Senior Contracting Specialist** position will support the Managed Care Team during system and new entities negotiations in accordance ... the direction of the Sr. Vice President and Vice President - Managed Care . Will be responsible for addressing operational, financial and services issues and… 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...by operational needs. Clinical expertise in geriatrics, Long Term care and Managed care experience… more
- 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
- 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
- VNS Health (Manhattan, NY)
- …of Milliman criteria (MCG) preferred For UM Only: Experience must be with a Managed Care Organization or Health Plan. For SelectHealth ETE Only: Experience in ... 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)
- …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
- 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
- Elevance Health (Morristown, NJ)
- …or related field and a minimum of 3 years experience in broad-based analytical, managed care payor or provider environment as well as experience in statistical ... **Provider Contract/Cost of Care Analyst Sr.** **Location:** This position will work...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
- Elevance Health (Morristown, NJ)
- …or related field; minimum of 5 years experience in broad-based analytical, managed care payor or provider environment; considerable experience in statistical ... **Provider Contract/Cost of Care Consultant** **We are offering a $5,000 sign-on...Works on complex enterprise-wide initiatives and acts as project lead . * Uses analytic tools to track both health… 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 Coordinator, Utilization Management** is a member of the healthcare… 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 Coordinator, Utilization Management** is a member of the healthcare… more
- Community Health Action of Staten Island (Staten Island, NY)
- …in lieu of some years of experience listed above. + Advanced knowledge of Medicaid/ Managed care billing is a plus. + Advanced computer skill, specifically ... color, and the LGBTQ community. POSITION SUMMARY: The Director of Care Management is the lead manager and administrator for the Medicaid funded Health Home… 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
- VNS Health (Manhattan, NY)
- …to develop, design, plan, and deliver information systems solutions to meet managed care payor needs. + Functions as lead Business Systems Analyst on team. ... visible projects to understand business needs and challenges of managed care payors and to develop innovative...leader and innovator in patient-centered and community-focused health care . At VNS Health, you'll have the opportunity to… 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