- Daiichi Sankyo, Inc. (Bernards, NJ)
- … Contract Forecasting to ensure support of cross-functional teams regarding key managed care accounts and ASP analysis. This includes: profitability analysis ... rare diseases and immune disorders. SummaryThe purpose of the Senior Director, Forecasting & Business Analytics is to lead...develop that knowledge; preferredDetailed knowledge of all channels of managed care environment in the US (commercial,… more
- Elliott Davis (Nashville, TN)
- …care and specialty physician practices, clinical research organizations, continuing care retirement communities, managed service organizations, and health IT. ... licensed CPA firm. Job Summary: The role of Audit Senior Manager is to oversee the audit process for...with our firms' private equity practice to support health care portfolio companies throughout their business life cycle. Tasks… more
- McKesson Corporation (Irving, TX)
- …you want to be part of tomorrow's health today, we want to hear from you. Contract Admin Senior Contract Specialist (P3) Job Description McKesson is in the ... customers on solutions - including supply management technology, world-class marketing programs, managed care and repackaging products and services - that help… more
- PIH Health (Whittier, CA)
- …for training employees to perform accurate and timely follow up of Commercial and Senior Managed care claims and all payer mix through resolution. ... Serves as a resource on PM computer systems and Contract specific regulations. Assists with follow up, assists with...credit balances, and correspondence from various Medi-Cal and or Managed Care HMO Plans. Review of Medi-Cal… more
- Sherman Oaks Hospital (Sherman Oaks, CA)
- …of contract interpretation 4. Familiar with hospital billing requirements 5. Understanding of managed care payor contract and contract language 6. ... Overview Sherman Oaks Hospital is a 153-bed, not-for-profit, acute- care community hospital located in Sherman Oaks, California. Staffed with over 500 employees and… more
- Pyramid Consulting, Inc. (Wolfforth, TX)
- …, or community setting and 1+ years of case management experience in a managed care setting. Knowledge of utilization management principles and healthcare ... Immediate need for a talented Senior LTSS Service Care Manager (RN)...Care Manager (RN) . This is a 06+months contract opportunity with long-term potential and is located in...managed care . Experience with medical decision support… more
- UPMC Senior Communities (Pittsburgh, PA)
- …complex situations accurately and in a timely manner. General knowledge of managed care functions and management techniques preferred. Licensure, Certifications, ... UPMC Community Care Behavioral Health is hiring a full-time Contract Specialist II. This role will predominantly work remotely but may require occasional… more
- State of Oregon (Portland, OR)
- …team oversees and ensures compliance with federal regulations for Oregon's Medicaid Managed Care program. The team is responsible for quality management ... quality control, assurance, planning, improvement initiatives, and contractual oversight of Managed Care Organizations (MCOs). The unit collaborates with… more
- Blue Shield of California (Long Beach, CA)
- …effective health care services based on medical necessity complying with contract for each appropriate plan type Provide Referrals to Quality Management (QM), ... you will determine, develop, and implement a plan of care based on accurate and comprehensive assessment of the...skills and ability to interact with all levels including senior management and influence decision-making. About the Team About… more
- LucyRx (Bethesda, MD)
- …Account Management experience Strong knowledge of PBM programs, pharmacy benefits, and managed care principles. Excellent customer service skills to maintain a ... Job Type Full-time Description The Senior Account Manager is responsible for providing exceptional customer service and fostering strong client relationships. Acting… more
- Stantec (Atlanta, GA)
- 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
- Power Engineers Incorporated (Meridian, ID)
- Senior DOD Project Manager POWER Engineers, Member of WSP's Government Services Business Unit is seeking a Senior Project Manager. The qualified candidate will ... ensuring adherence to scope, schedule, and budget Team management and participation projects managed by a joint venture (JV) Management of project change orders and … more
- Ivy Rehab Network (White Plains, NY)
- … contract negotiations with commercial payers, Medicare Advantage plans, Medicaid managed care organizations, and other third-party payers Analyze market ... of Payor Contracting to lead Ivy Rehab's payer relationship management and contract negotiations. This senior leadership position will oversee all aspects… more
- UnitedHealth Group (Minneapolis, MN)
- …related to assigned legal projects Solid understanding of health insurance and/or managed care industry Solid understanding of business, accounting and finance ... At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care . The work you do here… more
- Healthfirst., Inc. (Brooklyn, NY)
- …Team (CMT) to maintain efficient and effective operations of Healthfirst's long term care plans such as CompleteCare and Senior Health Partners. Duties and ... home care agencies and CMT regarding home care issues and contract nurses and aides...understand and are in agreement with enrollment in a managed long-term care plan Additional duties as… more
- UnitedHealth Group (Minnetonka, MN)
- …be interested in. Required Qualifications: 10+ years of experience working within the PBM/ managed care pharmacy industry and deep understanding of its evolving ... Optum is a global organization that delivers care , aided by technology to help millions of...Plan segment is accountable for the overall success and contract execution of high-profile large Health Plan clients. As… more
- Cigna (Independence, OH)
- …Intimate understanding and experience with larger, more complex integrated delivery systems, managed care , and provider business models. Team player with proven ... impact of high spend or increasingly complex provider contracts and alternate contract terms. Manages key provider relationships and is accountable for interface… more
- Restaurant Associates (Chicago, IL)
- …progressive food service management experience 5+ years experience Large Scale Multi-Client/ Contract Managed Service Associates at Restaurant Associates are ... solutions to problems. Essential Functions: Demonstrate and Lead R/As culture of CARE Plan and advise business portfolio that achieves Key Performance Indicators… more
- Cascadia Search Group (San Francisco, CA)
- …Regional Payer accounts while building a strong corporate presence with key managed care and formulary decision-makers and other appropriate stakeholders. This ... business writing and presentation skills Proven record of success in managing managed care accounts in assigned geography Ability to anticipate customer… more
- Corvel (Lawrenceville, GA)
- …Demonstrated experience in management or supervision Training within the insurance industry, managed care or related field preferred PAY RANGE: CorVel uses ... that all service expectations are identified and maintained. Communicate and engage senior management in account status, challenges and goals. Every national account… more
