- Mount Sinai Hospital (New York, NY)
- … contracting , finance, IT, analytics, operations, and product development expertise. The Managed Care Contracting Team within MSHP is responsible for ... to keep entire communities healthy and out of the hospital . Mount Sinai Health Partners (MSHP) is the team...Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as… more
- Cigna (Fort Lauderdale, FL)
- …considered in lieu of a bachelor's degree. MBA or MHA preferred. 3+ years Managed Care contracting and negotiating experience involving complex delivery ... visit Providers 3 days per week The Manager, Provider Contracting Network Management serves as an integral member of...relationships with provider partners. Intimate understanding and experience with hospital , managed care , and provider… more
- Mount Sinai Hospital (New York, NY)
- … personnel as needed. The Nursing Clinical Manager collaborates with Appeals Management, Managed Care Contracting and other institutional departments to ... day activity supports the mission of efficient and clinically appropriate patient care . 4. Demonstrates integral involvement in the Nursing Department PI/QA program.… more
- Sheppard Pratt (Amesbury, MA)
- …role regarding new and/or revised procedures and programs. Works with staff of the Managed Care Contracting office in response to requests for information, ... of patients admitted to the Hospital for Inpatient and Day Hospital levels of care . Trains or ensures the proper training of newly hired Utilization Review… more
- Ann & Robert H. Lurie Children's Hospital of Chicago (Chicago, IL)
- …Thorough knowledge of patient accounting, third party payer procedures, governmental regulations and managed care contracting to be effectively proactive in ... Ann & Robert H. Lurie Children's Hospital of Chicago provides superior pediatric care...coding, medical terminology, third party billing and collections, and managed care requirements. 4. Excellent communication/listening skills.… more
- Vertex Pharmaceuticals (Boston, MA)
- …and incorporate contracting strategies and tactics, and understand the various types of managed care contracting . This is a highly visible role that will ... biopharmaceutical industry, including but not limited to specialty pharmacy, provider and managed care payors is required (health plans, pharmacy benefit… more
- University of Illinois Hospital and Health Sciences System (Peoria, IL)
- …relationships as needed to meet strategic needs of the MSP. Negotiate with managed care organizations. Ensure that review of monthly financial reports is ... of 3 years of supervisory experience required. Thorough knowledge of contracting and negotiating, medical billing and clinical practice operations are required.… more
- BG Consulting Services LLC (Bethesda, MD)
- …referral record accordingly. 6. Determine appointment needs according to local and regional managed care rules. Validates and implements MTF policy in support of ... hospital accreditation program and quality improvement efforts. 7. Search...health care delivery systems, military management health care principles and techniques, TRICARE Managed Health… more
- Hackensack Meridian Health (Hackensack, NJ)
- …& levels of appeal iv. Root cause analysis & trends v. Participation in Managed Care Contracting & distribution of contract terms where appropriate ... Medical Center. These include but are not limited to utilization review, hospital reimbursement, clinical compliance, case management, and transitions of care ,… more
- UHS (Riverside, CA)
- …and State laws and regulations (Centers for Medicare and Medicaid Services, Department of Managed Health Care , Department of Health Care Services, CA ... Compliance Program principles to include analyzing risk assessments, performing audits, contracting , creating reports, educating and following up with the business… more
- CenCal Health (Santa Barbara, CA)
- …Knowledge/Skills/Abilities Required: In-depth knowledge of the principles and practices of managed care related to utilization management and case management ... Medical Director is responsible for providing clinical oversight for utilization, quality, care management and credentialing functions in a manner that ensures the… more
- Teva Pharmaceuticals (Parsippany, NJ)
- Associate Director, Managed Care Payer Contracting Date: Jul 22, 2025 Location: Parsippany, United States, New Jersey, 07054 Company: Teva Pharmaceuticals ... the next generation of pharmaceutical access in a high-growth environment.** The Associate Director, Managed Care Payer Contracting plays a pivotal role in… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …care sites and clinicians are recognized for clinical and operational excellence. **DIRECTOR MANAGED CARE CONTRACTING - LARGE ACCOUNTS** **| REMOTE** This ... developing, managing, and leading the day-to-day activities associated with managed care contracting for both...or closely related field + 10 years' experience of hospital contracting or payer contracting … more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Director Managed Care Contracting position is responsible for the development, negotiation, maintenance and payer relations of the ... + Knowledge of acute care contracts, financial modeling techniques and managed care contracting , contract pricing, language requirements, rates and… more
- Teva Pharmaceuticals (Parsippany, NJ)
- Director, Managed Care Payer Contracting (V&A) Date: Jul 3, 2025 Location: Parsippany, United States, New Jersey, 07054 Company: Teva Pharmaceuticals Job Id: ... a difference, and new people to make a difference with. **The opportunity** The Director, Managed Care Payer Contracting is a key leadership role within… more
- RWJBarnabas Health (Jersey City, NJ)
- …on business and clinical operations, nursing, social work, hospital networks and managed care contracting + Works collaboratively with local executive ... processes. + Maintains a thorough understanding of clinical reimbursement and managed care issues specific to an oncology service line. Identifies opportunities… more
- The Cigna Group (Richmond, VA)
- …strong external relationships with provider partners. + Intimate understanding and experience with hospital , managed care , and provider business models. + ... Washington, DC or the Baltimore, MD area.** This **Manager, Hospital Contracting ** serves as an integral member...of life. We guide our customers through the health care system, empowering them with the information and insight… more
- Cedars-Sinai (Los Angeles, CA)
- …related field Work Experience: + **Minimum of 10 years of progressive experience** in managed care contracting at the management or supervisory level, within ... a large, diverse health system, with specific experience in ** hospital and physician contracting ** . Must have...Managed Care and Payor Relations Director, Managed Care - #1 Hospital … more
- Parkview North Hospital (Fort Wayne, IN)
- …field. MBA/MHA a plus. Experience: Minimum of five to seven years experience in managed care , plus value-based care or clinical integration arena with ... and leads a variety of duties associated with payor contracting analytics. Acts as the senior lead analyst mentoring...constant improvement in knowledge of trends in value based managed care . Demonstrated proficiency with software programs… more
- Albany Medical Center (Albany, NY)
- …and payer relationships. + Demonstrated knowledge of current federal and NYS regulations regarding managed care contracting , as well as the provision and ... all federal, state, and local regulations for governing payer contracting , stays informed of the health care ...complex health care setting that included payer contracting - preferred + Hospital , physician group… more
