• Eisai, Inc (Nutley, NJ)
    …provides to patients, their families, and caregivers is Eisai's human health care (hhc) mission. We're a growing pharmaceutical company that is breaking through ... If this is your profile, we want to hear from you. The Director , HCP Marketing, Alzheimer's Disease will lead several core marketing, strategy, and lifecycle… more
    HireLifeScience (07/01/25)
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  • 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 ... Executive Director for Fiscal Affairs Hiring Department : UICOMP-Dean's...is now accepting applications for the position of Executive Director for Fiscal Affairs. We are looking for a… more
    Upward (07/11/25)
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  • Copious Staffing Solution (Houston, TX)
    …assertive Background in business planning, and targeted outcomes Working knowledge of managed care , inpatient, outpatient, and the home health continuum, as ... About the job Director , Care Management The Director...Director is responsible for monitoring the progress of hospital department activities related to discharge planning and clinical… more
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  • 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 ensure ... implementation of new Institutional initiatives. The NCM reports to and assists the Director of Case Management in providing ongoing education to Case Managers and… more
    Upward (07/21/25)
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  • Athena Health Care Systems (Bristol, CT)
    We are hiring a Director of Nursing Services to join our dynamic care team at Sheriden Woods Health Care Center in Bristol! Sheriden Woods, a 146-bed skilled ... employment in short-term hospital or chronic disease hospital as Director of Nurses, Assistant ...of personal characteristics, are encouraged to apply. Athena Health Care Systems and its managed centers follow… more
    Upward (07/14/25)
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  • StateJobsNY (Buffalo, NY)
    …innovative leader who can execute strategic decisions to serve as Deputy Director of the Western NY (WNY) Developmental Disabilities State Operations Office (DDSOO) ... of the Commissioner of OPWDD and reports directly to the Region 1 DDSOO Director . The selected candidate will serve at the executive level for the Region, providing… more
    Upward (07/25/25)
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  • Fort Duncan Regional Medical Center (Eagle Pass, TX)
    …in acute care , utilization review, case management. Strong working knowledge of hospital billing, managed care systems, and discharge planning. Excellent ... collaborative healthcare setting. About Fort Duncan Regional Medical Center Acute care hospital with 101 private rooms, advanced imaging (CT, MRI, ultrasound,… more
    Upward (07/13/25)
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  • Compass Group (Chicago, IL)
    …the successful operation of multiple Food & Nutrition Services in more than one Acute Care Hospital in a given geography. MUST RESIDE IN CHICAGO IL Key ... service team members. Job Summary Job Summary: The System Director of Dining Services is a key leadership position...related experience preferred Minimum of seven plus years of hospital or adult home/ care experience preferred, depending… more
    Upward (07/13/25)
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  • Vertex Pharmaceuticals (Boston, MA)
    …discuss and incorporate contracting strategies and tactics, and understand the various types of managed care contracting. This is a highly visible role that will ... Job Description Reporting to the Director , Contract Operations, this role is responsible for...including but not limited to specialty pharmacy, provider and managed care payors is required (health plans,… more
    Upward (07/01/25)
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  • Franciscan Missionaries of Our Lady Health System (Jackson, MS)
    …responsibilities. Responsibilities Partnership and Collaboration: a. A working knowledge of Managed Care Contracts, third party payor criteria and InterQual ... or adjustments to treatment plan to promote continuum of care as evidenced by documentation and no denials. e....by documentation. e. Prompt notification of UM Manager or Director of possible quality or physician issues as evidenced… more
    Upward (07/11/25)
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  • Athena Health Care Systems (Sandwich, MA)
    …and active RN license in the state. A minimum of one (1) year in a hospital , long-term care facility, or other related health care facility is preferred, ... individuals, regardless of personal characteristics, are encouraged to apply. Athena Health Care Systems and its managed facilities/agencies follow federal and… more
    Upward (07/05/25)
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  • DHR Health (Edinburg, TX)
    …Knowledge in the areas of case management and utilization management, experience with Managed Care and utilization management as it relates to third-party payers ... years clinical experience is required, with experience in a Hospital or acute care setting being strongly...line reviews on potential quality issues as requested by director Refers all other potential quality of care more
    Upward (07/07/25)
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  • Prompt Care Companies Inc (Mansfield, OH)
    …sources such as physicians, case managers, respiratory departments, dietitians, payors, and managed care organizations. The AE is responsible for identifying ... the company. In this role, the AE supports the Director of Sales by mentoring the Branch Respiratory Sales...budget goals. Ideal candidates will have strong experience in hospital -based respiratory sales or related fields (eg, Home Health,… more
    Upward (07/13/25)
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  • Avalon Health Care Management Inc. (Pasco, WA)
    …Assessment Coordinator will be responsible for all of the facility Medicare and Managed Care residents as directed by the Resident Assessment Director ... families. Full-time are eligible for: 401K Dental & Vision FSA & Dependent Care FSA Life Insurance AD&D, Long Term Disability, Short Term Disability Critical… more
    Upward (07/21/25)
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  • Baylor Scott & White Medical Center - Frisco (Frisco, TX)
    …not paid correctly according to Managed Care contracts. Supports hospital department policies, department director and hospital administration. Lends ... of experience in hospital insurance collections, processing, commercial, and managed care claims preferred. Computer knowledge, including knowledge of… more
    Upward (07/08/25)
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  • Enterprise Solutions, Inc. (Gainesville, FL)
    …on timely basis in accordance with the NFRMC Utilization Review Plan and managed care contractual agreements. Submits clinical information to insurance companies ... Name: Case Management Facility Name: HCA Florida North Florida Hospital Available Shifts: Day shift: 8:00 AM 4:30 PM... is a 523-bed, full-service medical and surgical acute care center. For over 49 years, we have served… more
    Upward (07/18/25)
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  • Boston Medical Center (Boston, MA)
    …and proper recording of any required hospital /department and or insurance of managed care requirements for proper recording and or billing of Radiology ... hospital . It's a network of support and care that touches the lives of hundreds of thousands...procedures as determined necessary through Supervisor and Radiology Administrative Director . POSITION SUMMARY: Under the general supervision of the… more
    Upward (07/26/25)
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  • Thomas Jefferson University Hospitals, Inc. (Philadelphia, PA)
    …preferred. Skills/Abilities: Must present polished professional image. Thorough understanding of managed care systems and utilization review criteria Recent ... or case management Knowledge of health insurance including Medicare, Medicaid and managed care Ability to work and communicate effectively with co-workers,… more
    Upward (07/17/25)
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  • MetroPlusHealth (New York, NY)
    …list of products, including, but not limited to, New York State Medicaid Managed Care , Medicare, Child Health Plus, Exchange, Partnership in Care ... Health (Serious Mental Illness & Substance Use Disorder) experience in managed care utilization review, quality assurance, discharge planning. (Experience… more
    Upward (07/13/25)
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  • Northern Light Health (Bangor, ME)
    …clinical leadership). Perform any duties and/or responsibilities assigned by Patient Care Director , for which qualified. Responsibilities : Effectively, and ... hospital capacity while ensuring the highest level of care for patients. The nurse collaborates with physicians, nursing...managed from its location in Bangor, Maine. Acadia Hospital is a leader in providing comprehensive inpatient and… more
    Upward (07/03/25)
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