- Elevance Health (Woodbridge, NJ)
- ** Provider Contract / Cost of Care Consultant** **Location:** This role requires associates to be in-office 1 day per week, fostering collaboration and ... an accommodation is granted as required by law. The ** Provider Contract / Cost of Care...or any combination of education and experience, which would provide an equivalent background. **Preferred Skills, Capabilities and Experiences:**… more
- CVS Health (Trenton, NJ)
- …to, claims payment, contract interpretation and parameters, or accuracy of provider contract or demographic information. + Negotiates settlements as needed. ... contract negotiator: + Negotiates competitive contracts with health care providers using pre-determined internal guidelines and financial standards. + Negotiates… more
- CVS Health (Trenton, NJ)
- …claims payment, contract interpretation and parameters, or accuracy of provider contract or demographic information. **Required Qualifications** -Minimum 4+ ... and adequacy targets. * Responsible for identifying and managing cost issues and initiating appropriate cost saving...provider configurations. - In-depth knowledge of the managed care industry, as well as a strong understanding of… more
- CVS Health (Trenton, NJ)
- …value based providers in one line of business, less complex Value Based Care models, and/or less sophisticated and smaller provider partnerships, practices, or ... arrangements are functioning successfully and working to improve quality of care while reducing costs. **Key Responsibilities:** + Provider Relationship… more
- Humana (Trenton, NJ)
- …of standardized templates, and policies to promote best practices. + Researchs provider contract details + Compares State Medicaid website payment terms ... in CAS + 2+ years' experience reviewing and interpreting provider contract language + 2+ years' ...and microwave connection can be used only if they provide an optimal connection for associates. The use of… more
- Humana (Trenton, NJ)
- …extensive business leadership experience, with several years in a managed care environment leading a network development/ provider relations function, including ... seeking an accomplished healthcare leader for the position of Vice President, National Provider Network Management. At a high level, this highly visible role will be… more
- BOOZ, ALLEN & HAMILTON, INC. (Wharton, NJ)
- Cost Analyst The Opportunity: The right mixture of great ideas and funding can create change. In a complex organization, allocating funding to where it can be most ... management strategy to help the client's ammunition acquisition and life-cycle by leading cost analysis efforts. You'll work directly with the client to develop an… more
- Qualus (South Plainfield, NJ)
- **Position Overview** **POWER** your future with Qualus as a Senior Cost Analyst in our Program Management organization. A Senior Cost Analyst provides cost ... forecasting and reporting, budget management and control, change management, contract administration, close-out administration, procurement management, earned value management,… more
- PSEG (Newark, NJ)
- …processes adherence and quality for variance analysis, forecasting as well as a comprehensive cost workbook. Review contract controller work as well as assist in ... experience to our more than 12,000 employees - we provide the resources and opportunities for career development that...500 company, as well as the attention, camaraderie, and care for one another you might typically associate with… more
- RWJBarnabas Health (Oceanport, NJ)
- …with the system business office to provide support relating to contract interpretation, denial reviews, payment variances, and cost -based audit reviews, + ... lead on modeling contract rates using EPIC throughout the managed care contract negotiation process, + Assists in varying aspects of managed care … more
- Centene Corporation (Trenton, NJ)
- …mental and behavioral health needs members to provide high quality, cost -effective healthcare outcomes including personalized care plans and education for ... between the member and/or family/caregivers, community resources, and the care provider team to ensure identified services...care and quality delivery for members in a cost -effective manner + Performs other duties as assigned. +… more
- Humana (Trenton, NJ)
- … efficiency, and population health outcomes through strategic provider partnerships, data-informed decision-making, and cross-functional collaboration. The RVP ... and maintain trusted relationships with CMOs and senior executive/clinical leaders at provider and care delivery partner organizations. First and foremost, this… more
- Intermountain Health (Trenton, NJ)
- …invoice to the contract . Participates as needed with authorized service provider contract negotiations. Provides notification to appropriate CE personnel of ... history records to reflect the current service agreement coverage. Manages the contract lifecycle for authorized service provider agreements, to include, but… more
- Prime Therapeutics (Trenton, NJ)
- …value to the customer, derived from identifying, demonstrating and selling valued pharmaceutical care and cost solutions that meet the desired outcomes of the ... fashion. + Demonstrates the value of pharmacy solutions (unit cost , utilization management & patient care enhancement)....achievements. We value new ideas and work collaboratively to provide the highest quality of care and… more
- Dr. Reddy's Laboratories (Princeton, NJ)
- …GPOs, Integrated Delivery Networks (IDN), institutional/community clinic practices and other provider networks. The person will direct the pricing and reimbursement ... GPO account teams, Field Sales, External customers, Legal and contract teams. The role will report to the Head...Buy & Bill Biologics space. Strong expertise in managed care landscape across medical and pharmacy benefit, commercial and… more
- Parsons Corporation (Atlantic City, NJ)
- …disability, veteran status or any other protected status. We truly invest and care about our employee's wellbeing and provide endless growth opportunities as ... Program Summary: The Federal Aviation Administration (FAA) awarded the Technical Support Services Contract 5 (T5) to Parsons in April 2023. Parsons is the prime… more
- Parsons Corporation (Newark, NJ)
- …for specific area. + Interface with other departments to provide scheduling/ cost data for items such as sub- contract change requests, bid comparisons, ... master service with task order contracts for a 15-year contract encompassing a broad range of strategic advisory services,...or any other protected status. We truly invest and care about our employee's wellbeing and provide … more
- Burns & McDonnell (Morristown, NJ)
- …for managing the construction project safety, quality, schedule, cost control, contracts, subcontractors, suppliers, proposals, estimates, documentation turnover, ... the successful execution of a single or multiple projects simultaneously. + Provide direction and participate in project planning, scheduling, estimating, cost … more
- Robert Half Finance & Accounting (Eatontown, NJ)
- …+ Responsible for the completion and review of the annual New Jersey Acute Care Hospital (SHARE) cost reports + Monitor and validate State and federal ... Plans + Short & Long Term Disability + Health Care /Dependent Care Flexible Spending Accounts + Wellness...+ Planning, preparing and reviewing of the annual Medicare/Medicaid cost reports filings. In partnership with the Vice President… more
- Parsons Corporation (Newark, NJ)
- …disability, veteran status or any other protected status. We truly invest and care about our employee's wellbeing and provide endless growth opportunities as ... Arcadis, and Mace (MPA) is the Delivery Partners (DP)to provide advice, leadership, and support to GDC for the...master service with task order contracts for a 15-year contract encompassing a broad range of strategic advisory services,… more