- Cigna (Newton, MA)
- …considered in lieu of a bachelor's degree. MBA or MHA preferred. 3+ years Managed Care contracting and negotiating experience involving complex delivery ... external relationships with provider partners. Intimate understanding and experience with hospital, managed care , and provider business models. Team player with… more
- Merck & Co. (North Wales, PA)
- …meta-analyses, and economic modelling. Key responsibilities also include development of American Managed Care Pharmacy (AMCP) dossiers for US payers, and Global ... and standards, including Good Pharmacoepidemiology Practice (GPP) for applicable work.-Develops American Managed Care Pharmacy (AMCP) dossiers for US payers, and… more
- Merck & Co. (Rahway, NJ)
- …meta-analyses, and economic modelling. Key responsibilities also include development of American Managed Care Pharmacy (AMCP) dossiers for US payers, and Global ... and standards, including Good Pharmacoepidemiology Practice (GPP) for applicable work.-Develops American Managed Care Pharmacy (AMCP) dossiers for US payers, and… more
- Merck & Co. (North Wales, PA)
- …meta-analyses, and economic modelling. Key responsibilities also include development of American Managed Care Pharmacy (AMCP) dossiers for US payers and Global ... and standards, including Good Pharmacoepidemiology Practice (GPP) for applicable work.Develops American Managed Care Pharmacy (AMCP) dossiers for US payers and… more
- Ewings Associates (Medina, WA)
- …field. 10+ years of progressive leadership experience in provider network development, managed care contracting , or healthcare operations. Expertise in ... value-based care models, risk-based contracting , and Medicare Advantage network development. Experience working with provider-sponsored health plans, commercial… more
- Teva Pharmaceuticals (Parsippany, NJ)
- …and new people to make a difference with. The opportunity The Associate Director, Managed Care Payer Analytics is responsible for leading the analytical strategy ... development Serve as a strategic partner to Account Management, Payer Contracting , Payer Marketing, Finance, Legal, and Compliance by delivering analytics that… more
- Martin's Point Health Care (Portland, ME)
- …8+ years of progressive actuarial experience in a wide range of medical expense analyses, contracting in a managed care setting, preferably in commercial and ... record of building internal and external collaborative relationships. Broad understanding of managed care business and financial principals such as underwriting,… more
- Molina Healthcare (Long Beach, CA)
- …in health care field including, but not limited to, provider's office, managed care , or other health care field. REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS ... contracting with large specialty or multispecialty provider groups. *1-3 Years Managed Care experience PREFERRED EXPERIENCE : Knowledge of integrated delivery… more
- Ewings Associates (Baltimore, MD)
- …experience. Keywords: VP of Revenue Cycle Operations, Director of Revenue Cycle, Managed Care Contract Analyst, Healthcare Financial Analyst, Provider Network ... Care , Reimbursement Modeling, Claims Data Analyst, Contract Negotiation, DRG/APC Modeling, Population Health Analytics, Payer Contracting , Alternative Payment… more
- Abbott (Alameda, CA)
- …the following key customer types: Mail Order, DME distributors, HME/DME dealers, and managed care customers along with developing and implementing internal DME ... you can do work that matters, grow, and learn, care for yourself and your family, be your true...divisional initiatives and contract development Assess business impact of contracting opportunities to include overall profitability and impact on… more
- Molina Healthcare (Long Beach, CA)
- …: *3 - 5 years customer service, provider service, or claims experience in a managed care setting. *3+ years experience in managed healthcare administration ... field-based position requiring an in-depth knowledge of provider relations and contracting subject matter expertise to successfully engage high priority providers,… more
- Suzanne Snell Human Resources and Recruiting Solutions (Newport Beach, CA)
- …verification is required Minimum of 2 years of experience in healthcare or a managed care setting Knowledge of HEDIS, STARS/Quality Measures and RAF/AV Programs ... Independent Physician Association serving Los Angeles and San Bernardino Counties, contracting directly with Health Plans to provide both inpatient and outpatient… more
- IES Communications (Tempe, AZ)
- …ensures that all contracted work is developed, implemented, installed and managed in accordance with the Company's requirements, including but not limited ... as possible with respect to staffing, materials management, financial management customer care and customer delivery goals. Job Duties and Responsibilities: 1. The… more
- Stantec (Washington, DC)
- Job Description When you care deeply about the work you do, it's rewarding to see it through from concept to completion. We partner with clients to provide both ... transit systems, water treatment facilities, mines, and wind farms, we've successfully managed thousands of projects. Joining our team, turning visionary ideas into… more
- Thomas Jefferson University Hospitals, Inc. (Philadelphia, PA)
- … care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage ... of multiple departments including the medical staff office, the legal/ contracting department, human resources, payer enrollment/credentialing and IT. The Program… more
- Argus Medical Management, LLC (Cypress, CA)
- …and manage all aspects of credentialing for healthcare providers within a managed care organization. Collect, review, and verify provider credentials, including ... Medical provides comprehensive billing and managements services which include contracting , credentialing, HR services, accounting, etc. to support Physicians in… more
- Elevance Health (Walnut Creek, CA)
- …experience preferred. Travels to the worksite and other locations as necessary preferred. Managed care experience preferred. For candidates working in person or ... Health family of brands, offering clinical programs and primary care options for seniors. We are a team of...via Web-Ex to support provider training on Carelon processes, contracting / credentialing and linkages for issue resolution, helping… more
- Inland Empire Health Plan (Rancho Cucamonga, CA)
- …and risk management; rules, regulations, policies, and standards related to managed care ; Principles of effective supervision and organization; methods, ... The Medical Director of Behavioral Health oversees the inpatient/concurrent review process, care integration efforts, and all levels of behavioral health care … more
- Trinity Health (Livonia, MI)
- …operational initiatives including new services/programs, revenue enhancement, expense reduction, managed care utilization systems, and strategies. Responsible ... people, processes and / or programs that support direct or indirect patient care . The Pharmacy Manager - Operations promotes and advocates for patients, pharmacists… more
- Optum NV (Las Vegas, NV)
- …5 STAR; disease-based metrics) in driving/achieving quality outcomes Working knowledge of managed care , and value based medicine Understanding of patient ... (RAF) Preferred Qualifications: 2+ years Quality Management experience Experience within managed care Working with senior leadership team to strategize… more
