- 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)
- …** at Hackensack Meridian _Health_ includes: + **Contract Negotiation & Network Management:** + Lead all managed care contract negotiations for HMH and its ... our mission to transform healthcare and serve as a leader of positive change. The **Senior Vice President (SVP)...+ Lead the development and execution of managed care contracting policies and strategies. Monitor… more
- 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
- 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
- Elevance Health (Woodbridge, NJ)
- …as a Case Manager is preferred. + Certification in the American Association of Managed Care Nurses preferred. + Broad clinical knowledge base of disease ... processes strongly preferred. + Prior managed care and case management experience preferred....is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
- Hackensack Meridian Health (Edison, NJ)
- …applicable. + Write Care Plans in EPIC Healthy Planet for high-risk patients being care managed . + Other duties and/or projects as assigned. + Adheres to HMH ... our mission to transform healthcare and serve as a leader of positive change. The ** Care Coordinator...Registered Nursing Program. + Minimum 2-3 years experience in managed care or health education/coaching is preferred.… more
- 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
- Hackensack Meridian Health (Edison, NJ)
- …knowledge and understanding of the different types of commercial carriers and managed care organizations, + effectively communicating specifics to persons ... our mission to transform healthcare and serve as a leader of positive change. **Responsibilities** A day in the...involved on all levels. Utilizes current managed care contract matrix, different insurancesystems and… 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
- 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 (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 Nurse Navigator** is a member of the healthcare team… more
- 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
- Graham Windham (Brooklyn, 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, Brooklyn Job Details Job Location 195...to create and implement innovative strategies so everyone can lead healthy, joyful, and successful lives. Principal Objective/Role Overview:… more
- Elevance Health (Woodbridge, 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
- 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
- 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 (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
- 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)
- …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