- Houston Methodist (Houston, TX)
- …compliance with ethical and legal business practices and accreditation/ regulatory /government regulations. **PEOPLE ESSENTIAL FUNCTIONS** + Provides direction to ... At Houston Methodist, the Vice President Managed Care position is responsible for the development,...for employee engagement, adequate staffing levels, budget development and compliance , to ensure a safe and effective work environment.… more
- Teva Pharmaceuticals (Parsippany, NJ)
- …view + Draft language that reflects negotiated terms and ensures legal and regulatory compliance + Create and maintain contract templates, playbooks and clause ... advanced degree preferred) + Minimum 7 years of experience in payer contracting, healthcare law, or managed care agreements (pharma/biotech or health insurance… more
- Cedars-Sinai (CA)
- …Completes focused reviews and special reports as requested. + Collaborates with the healthcare team to implement strategies to resolve system issues. + Serves as the ... the network's membership. + Monitors and Tracks all other aspects of Managed Care, quality & efficiency measures, Star ratings, access, physician network integrity,… more
- AmeriHealth Caritas (Raleigh, NC)
- …and Exchange product lines, including network design, contract negotiations, and regulatory compliance . + Oversee contracting efforts across all provider ... stay well, and build healthy communities. As one of the nation's leaders in healthcare solutions, we offer our associates the opportunity to impact the lives of… more
- Teva Pharmaceuticals (Parsippany, NJ)
- …contractual agreements that reflect sound legal and financial terms while ensuring compliance with company policies and regulatory requirements. The Sr. Manager ... advanced degree preferred + Minimum 6 years of experience in payer contracting, healthcare law, or managed care agreements (pharma/biotech or health insurance… more
- Baystate Health (Springfield, MA)
- …contracting projects and issues. **Required Work Experience:** **1)** 5 years of Healthcare , Managed Care, Provider, or payer expertise **Preferred Work ... Expertise** + Ability to analyze payor contracts for financial impact, compliance , and strategic value. + Experience in negotiating fee-for-service and value-based… more
- MaineGeneral Health (Waterville, ME)
- …and payer enrollment. The successful candidate will have a deep understanding of healthcare finance, regulatory requirements, and a proven track record in a ... or related field (Master's preferred) + Minimum of 7 years of experience in healthcare reimbursement and managed care - some leadership experience is preferred +… more
- Henry Ford Health System (Troy, MI)
- GENERAL SUMMARY: Reporting to the Director - Managed Care Contracting, this position is responsible for managing the payor contracting functions for the hospitals, ... of Henry Ford Health. This position is responsible for leading the Managed Care Contracting team in evaluating, analyzing, and negotiating contract terms and… more
- Cedars-Sinai (Beverly Hills, CA)
- …metrics, identifying trends, variances, and areas for improvement. + Analyze managed care contracts for compliance and financial performance, identifying ... implementation financial initiatives; assisting in the interpretation of policies/procedures/practices. Managed Care Reporting: + Prepare reports and presentations to… more
- UCLA Health (Los Angeles, CA)
- …manage multiple priorities and deadlines independently. + Experience coordinating audits, regulatory compliance , and internal performance improvement efforts. + ... Description UCLA Health is seeking a dynamic Program Manager to support the Managed Care Operations team. This role is instrumental in overseeing the execution of… more
- Teva Pharmaceuticals (Parsippany, NJ)
- Director, Managed Care Payer Contracting (V&A) Date: May 6, 2025 Location: Parsippany, United States, New Jersey, 07054 Company: Teva Pharmaceuticals Job Id: 61853 ... crafting cutting-edge contracting strategies that navigate a complex landscape.** The Director, Managed Care Payer Contracting is a key leadership role within Value… more
- Sharp HealthCare (San Diego, CA)
- …to work independently, yet can facilitate interdisciplinary teams in achieving regulatory compliance + Skilled in process improvement methodologies **Essential ... regulation. Work closely with hospital administration, clinical departments and external regulatory agencies to develop, implement and monitor compliance … more
- Teva Pharmaceuticals (Parsippany, NJ)
- Director, Managed Care Payer Data & Analytics (V&A) Date: May 6, 2025 Location: Parsippany, United States, New Jersey, 07054 Company: Teva Pharmaceuticals Job Id: ... data infrastructure for payer contracting analytics + Monitor industry and regulatory changes impacting reimbursement methodologies and payer trends (HCR, IRA, for… more
- Sutter Health (Goleta, CA)
- …(TJC). A broad knowledge base of post-acute levels of care and associated regulatory compliance requirements. Must be able to effectively communicate with, and ... & LICENSURE:** + RN-Registered Nurse of California + BLS-Basic Life Support Healthcare Provider + CCM - Certified Case Manager (certification may be required… more
- Zebra Technologies (Holtsville, NY)
- …customers, and the world. Let's create tomorrow together. The Senior Manager Product Regulatory Compliance provides management of Regulatory team and related ... and controls the activities of individuals/teams in a functional discipline within a regulatory compliance group, division, sub-region or country. + Develops … more
- US Tech Solutions (Columbia, SC)
- …Utilizes clinical proficiency, claims knowledge/analysis, and comprehensive knowledge of healthcare continuum to assess, plan, implement, coordinate, monitor, and ... system for clinical information flow and proper claims adjudication. Demonstrates compliance with all applicable legislation and guidelines for all regulatory… more
- Good Samaritan Society (Elk Horn, IA)
- …facility planning, activities, and responding to and identifying needs to ensure regulatory compliance . Will coordinate all aspects of the facility's operation ... operations and realization of enterprise goals. **Qualifications** Bachelor's degree in healthcare required. Three years' experience as a Nursing Home Administrator… more
- J&J Family of Companies (Horsham, PA)
- … Compliance and FDA Update training, Promotional Review Copy (PRC) Meetings, HealthCare Compliance Teams, Global Regulatory Functional Teams, Product ... problems/opportunities by generating alternatives to achieve desired outcomes. + Conduct Regulatory Compliance reviews as a member of multi-disciplinary team… more
- Molina Healthcare (Lincoln, NE)
- …Public Health, Social Work, or related field. **Required Experience** + 5+ years of managed healthcare experience, including 3 or more years in one or more ... **Preferred Experience** + 3+ years supervisory/management experience in a managed healthcare environment. + Medicaid/Medicare Population experience with… more
- Banner Health (AZ)
- …organization adheres to all applicable regulations and standards within Facility Operations. Regulatory compliance is not just a requirement; it's a cornerstone ... in the near future! If you are passionate about regulatory compliance and eager to make a...Healthcare Facility Manager. Certified Facility Manager. Any applicable healthcare or regulatory industry related certifications or… more
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