- 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, ... Job DescriptionThe Central Contract Services (CCS) Senior Specialist will function as a vital member of...stakeholders in the development and pull through of all managed care contract, price, eligibility, and chargeback… 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 ... they serve. **Healthcare Data Specialist 1 in Albany,... Contracting and Oversight's Bureau of Consumer Service's Managed Long Term Care Complaints Unit. Additional… 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 ... LLC (PCG), is focused on delighting clients with world-class managed staffing and talent consulting services. SSO is committed...clients and the people they serve. **Senior Healthcare Data Specialist 1 in Albany, NY** **Division of Health Plan… 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)
- …Strong claims experience + Mentoring subject matter expert of the team + Managed Care experience (preferably Medicare/Medicaid) + Experience in health plan ... Engagement & Performance **Position Summary:** The Senior Provider Relations Specialist is responsible for building, maintaining and strengthening relationships with… more
- Molina Healthcare (Miami, FL)
- …in health care field including, but not limited to, provider's office, managed care , or other health care field. **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS ... **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy...large specialty or multispecialty provider groups. * 1-3 Years Managed Care experience **PREFERRED EXPERIENCE** : Provider… more
- HCA Healthcare (Campbell, CA)
- …of health plan economics analyses, metrics and health plan reporting in a Managed Care environment relating to the financial, quality and operational performance ... Come join our team as a Health Plan Economics Specialist . We care for our community! Just...for Health plan Metrics, Analytics and Reporting for a Managed Care organization + Develop and maintain… more
- BayCare Health System (FL)
- …resolves errors and issues by coordinating with the plans/payors, the CBO and the Managed Care contracting department. + This includes ensuring the ... and processes provider applications for renewals reappointments. + Enrolls and maintains managed care enrollment for providers by providing updates to the… more
- Merck (North Wales, PA)
- …of MS Word and Excel **Preferred** + 3+ years business experience in Managed Care Contracting or Pharmaceutical industries. **Required Skills:** ... **Job Description** The Central Contract Services (CCS) Senior Specialist will function as a vital member of...stakeholders in the development and pull through of all managed care contract, price, eligibility, and chargeback… more
- Houston Methodist (Sugar Land, TX)
- …+ Maintains knowledge of Federal, State, and local billing regulations and partners with managed care contracting as needed. + Maintains knowledge of ... determinations and, denial reason and trending as appropriate, Monitors CMS, managed care and payor communications for updates/alerts/releases and functions… more
- CareFirst (Baltimore, MD)
- …management experience on the payer side using MCG criteria. Working knowledge of managed care and health delivery systems. + Thorough knowledge of CareFirst ... Utilizing key principles of utilization management, the Utilization Review Specialist will perform prospective, concurrent and retrospective reviews for… more
- CareFirst (Baltimore, MD)
- …years experience in risk adjustment coding, ambulatory coding and/or CRC coding experience in managed care ; state or federal health care programs; or health ... submissions. Utilizes coding expertise, combined with medical policy, credentialing, and contracting rules knowledge to build the effective guides and resources for… more
- Waystar (Atlanta, GA)
- …Develop and maintain strong relationships with payers, including health insurance companies, managed care organizations, and government agencies. + Create new, ... **ABOUT THIS POSITION** The Payer Relations Specialist is responsible for initiatives to identify and...performance. + Track and communicate the status of payer contracting and connections activities **OPTIONAL DETAILS --Looking for… more
- AmeriHealth Caritas (Philadelphia, PA)
- … care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral ... Your career starts now. We're looking for the next generation of health care leaders. At AmeriHealth Caritas, we're passionate about helping people get care ,… more
- Molina Healthcare (Rockford, IL)
- …will have the following experience-** + Live in Illinois and are familiar with Managed Care in Illinois and how HHF operates. + Background/experience in business ... Molina Healthcare is hiring a Sr Specialist in our Government Contracts department. This role...field. **Required Experience** + 3 years' experience in a managed care environment. + Experience demonstrates strong:… more
- Carnival Cruise Line (Miami, FL)
- …Effectively coordinate and collaborate with stakeholders to ensure ownership and contracting is deliberately/consciously managed and applied. + Measuring and ... something for everyone. We are looking for an amazing Specialist , Training Governance to fill this role, which is...targets are met and that corporate reporting requirements are managed . + Responsible for all governance group preparation and… more
- Compass Group, North America (Charlotte, NC)
- …the world's largest contract food and support services provider. **Why Foodbuy?** We care about our associates, our clients, and our community. We think big, ... business partners and fellow associates. **Job Summary** The Sr. Data Intelligence Specialist role sits in out our Termset Management, Operations Department and is… more
- Nuvance Health (Danbury, CT)
- …on a daily/regular basis with the Denials Management team. * Assists with informing Managed Care contracting team with necessary contractual language to ... * Current working knowledge of utilization management, performance improvement and managed care reimbursement. Working Conditions: Manual: Some manual… more
- Molina Healthcare (West Valley City, UT)
- …or equivalent combination of education and experience **Required Experience** + 3-5 years managed care experience, including 2+ years in Provider Claims and/or ... level (or higher) **Preferred Education** Bachelor's Degree **Preferred Experience** + 5+ years managed care experience + QNXT; SQL experience + Crystal Reports… more
- Veterans Affairs, Veterans Health Administration (Asheville, NC)
- …Commodity Management Division of the Logistics Service in a Veteran Affairs Health Care System (VA HCS) and supported catchment area, with responsibility for the ... matter expert to all services and Service lines. Inventories managed include a wide variety of expendable items and...affect the VA HCS' ability to provide medical grade care to Veterans. Researches opportunities for and conducts analysis… more
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