- Stanford Health Care (Palo Alto, CA)
- …+ Knowledge of accounting, healthcare reimbursement, financial forecasting, operations analysis, managed care contracting , capitation management, general ... of expected and actual revenue and contractual allowances for all payors including managed care , Medicare, Medi-Cal, commercial, and self pay payors. Oversee the… more
- Merck & Co. (North Wales, PA)
- …of MS Word and Excel - -Preferred- 3+ years business experience in Managed Care Contracting or Pharmaceutical industries. Required Skills: Accountability, ... and stakeholders in the development and pull through of all managed care contract, price, eligibility, and chargeback activities, inquiries, and issue… more
- Children's Hospital Los Angeles (Los Angeles, CA)
- …Statement/Position Summary:** This position is responsible for directing and coordinating the managed care policies, goals, and objectives related to contract ... Group leadership in working with Physician Organizations in the market regarding managed care contracts, strategies for improving market share and opportunities… more
- Commonwealth Care Alliance (Boston, MA)
- …experience in provider relations, network management, or healthcare operations within a managed care organization, health plan, or integrated delivery system. - ... leads the strategic vision and operational execution of provider relations for Commonwealth Care Alliance's SCO and One Care lines of business. This role… more
- Staffing Solutions Organization (Albany, NY)
- …NY** **Division of Health Plan Contracting & Oversight (DHPCO) Item 1014** **Medicaid Managed Care and Managed Long-Term Care (MLTC) Cost Reporting** ... of Health Insurance Programs (OHIP), Division of Health Plan Contracting and Oversight (DHPCO), in the development and oversight...(DHPCO), in the development and oversight of the Medicaid Managed Care and Managed Long-Term… more
- Commonwealth Care Alliance (Boston, MA)
- …changes, ever-rising costs, and a lack of capacity and access to quality care . These challenging circumstances have emphasized the need for innovative care ... millions of people do not have access to proper care and visit Emergency Departments because they have no...of each growth opportunity into existing instED operations, from contracting to go-live.. Within this team, the Implementation Manager… more
- Commonwealth Care Alliance (Boston, MA)
- …Bachelor's Degree or equivalent experience **Experience (Required)** + 3-5 years + Managed Care experience + Experience in health plan provider relations. ... responsible for cultivating, maintaining and strengthening relationships with the Commonwealth Care Alliance's (CCA) provider community. In this highly visible field… more
- Commonwealth Care Alliance (Boston, MA)
- …active RN license required Required Experience: - 7-10 years - 8-10 years of managed care operations experience, including a minimum five (5) years of leadership ... care delivery Required Knowledge, Skills & Abilities: - Medicare and Medicaid managed care experience - Demonstrated knowledge of federal and state… more
- Staffing Solutions Organization (Albany, NY)
- …NY** **Division of Health Plan Contracting & Oversight (DHPCO) Item 1347** ** Managed Long Term Care (MLTC) Complaints Unit** **Summary:** The person in this ... and evaluation activities within the Division of Health Plan Contracting and Oversight's Bureau of Consumer Service's Managed... Contracting and Oversight's Bureau of Consumer Service's Managed Long Term Care Complaints Unit. Additional… more
- Commonwealth Care Alliance (Boston, MA)
- …Strong claims experience + Mentoring subject matter expert of the team + Managed Care experience (preferably Medicare/Medicaid) + Experience in health plan ... for building, maintaining and strengthening relationships with the Commonwealth Care Alliance's (CCA) diverse provider community - including physician, hospital,… more
- Commonwealth Care Alliance (Boston, MA)
- …(must have):** + 5+ years of experience working within community-based health and/or managed care **Desired Experience (nice to have):** + Experience working ... The role supports efforts of the organization's Network and Provider Contracting department and will have regular interaction with relevant internal Clinical,… more
- Novo Nordisk Inc. (Plainsboro, NJ)
- …Efficiently and accurately forecast gross to net components including but not limited to Managed Care , and Medicare Part D, Medicaid as well as current and ... platforms Serve as internal consultant with Finance, Pricing & Contracting , Commercial and Strategy teams Responsible for gross-to-net forecasting process… more
- Mom's Meals (Ankeny, IA)
- …channel growth through continued development of relationships at Medicare Advantage (MA) Managed Care Plans. The position will concentrate on expanding knowledge ... business expansion meetings + Cross collaborate with implementation, customer care , intake, data analytics, IT, contracting , revenue...5+ years' healthcare sales experience in areas such as managed care , long-term care , home… more
- Staffing Solutions Organization (Albany, NY)
- …and analysis associated with the transition and monitoring of vulnerable populations into managed care . **Duties include:** + Conduct in-depth online research on ... Public Consulting Group LLC (PCG), is focused on delighting clients with world-class managed staffing and talent consulting services. SSO is committed to a diverse… more
- Staffing Solutions Organization (Albany, NY)
- …their rights. + Provide current and accurate guidance to complainants regarding Medicaid Managed Care services and benefits. + Maintain an organized work ... Office (NYSOH) + Experience in investigating issues in enrollment and eligibility and Managed Care Plan regulatory compliance + Knowledge of medical terms and… more
- Merck & Co. (North Wales, PA)
- …VP Market Access, Trade and Pricing, US Brand Marketing team and the Managed Markets and Policy (MM&P) organization to support overall objective to achieve ... in both the current business model and explore future sites of care /business models to achieve profitable market access for Ohtuvayre. Responsibilities include and… more
- Daiichi Sankyo, Inc. (Bernards, NJ)
- …creation and supply of innovative pharmaceutical therapies to improve standards of care and address diversified, unmet medical needs of people globally by leveraging ... including budget for individual meetings.- Manage and influence site selection, contracting and negotiation process for the venue.- Oversees the timeline for… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …+ Four (4) years of clinical program development,managementor consultation in a managed care setting **(Required)** + Board Certified in Oncology Pharmacy ... (HighlyPreferred) + Experience in managed care pharmacy + Experience and/or familiarity with EHR, Oncology provider practices, specialty pharmacy practices,… more
- Hartford HealthCare (Hartford, CT)
- …**Organization:** **Hartford HealthCare Corp.* **Title:** *Sr Payer Analyst / Managed Care Contracting * **Location:** *Connecticut-Hartford-100 Pearl ... of Payer Contract Analytics, the Sr. Payer Analyst is responsible for payer contracting analytics with a focus on hospital and ancillary. Reviews and monitors… more
- Guidehouse (Chicago, IL)
- …translates healthcare data into measurable healthcare financial performance. This role is dedicated to managed care contracting - you will learn to read ... AR days, first pass yield, cash acceleration, net revenue). + Work with Managed Care /Finance, Revenue Integrity/CDM, PFS, and IT/Data teams to align… more
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