- WTW (New York, NY)
- …Wealth and Career and Risk and Broking. The Managed Care Growth Leader is the primary client lead managing the totality of the Willis Towers Watson ... (WTW) relationship for clients within the Managed Care Industry. This individual is accountable...business while managing existing revenue and profit streams + Lead the development and execution of client account plans… more
- Centene Corporation (New York, NY)
- …guidance and support to clinical new hires/preceptees in navigating within a Managed Care Organization (MCO) and provides coaching and shadowing opportunities ... Registered Nurse License** **Position Purpose:** Assesses, plans, and implements complex care management activities based on member activities to enable quality,… more
- City of New York (New York, NY)
- …State agencies (eg, SDOH, SOMH, OASAS, OPWDD), community health, mental health, and managed care organizations around child mental health services at DHS. ... of succeeding in permanent housing and independent living, improving access to care and health outcomes for low-income and vulnerable populations. The Office brings… more
- City of New York (New York, NY)
- …impact of the 2022-2027 NYS Medicaid 1115 Waiver on public health outcomes. - Lead managed care collaboration initiatives for COVID-19 management and ... Local, State, and Federal legislation, policies, and programming. Medicaid Managed Care and Medicare Advantage payment and...78], Local Law 52 Local Law 163, etc.). - Lead efforts to maximize impact of NYS AHEAD model.… more
- Stony Brook University (East Setauket, NY)
- …Care Hospital Revenue Cycle or Patient Accounting Department resolving hospital Managed Care payment variances and/or denials. **Job Responsibilities may ... **Senior Revenue Cycle Specialist** will act as an operational leader in the Hospital's Business Office to analyze, track,...staff regarding departmental and unit policy and procedure, including: Managed Care Contracts. + Monitors work queues… more
- Mount Sinai Health System (New York, NY)
- …clinical, contracting, finance, IT, analytics, operations, and product development expertise. The Managed Care Contracting Team within MSHP is responsible for ... Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as...Issues: * Proactively escalate issues to Directors that could lead to significant legal ramifications or require intervention by… more
- Molina Healthcare (New York, NY)
- …and experience **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:** * 8+ years of Medicaid managed care experience or in an equivalent related field * Ability ... with Medicaid Proposals and/or business development and requires demonstrated Medicaid managed care experience comprised of technical operational, sales, growth,… more
- Molina Healthcare (New York, NY)
- …guidelines. + Experience in Utilization/Quality Program management + HMO/ Managed care experience **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** ... and action plan, which includes strategies that ensure a high quality of patient care , ensuring that patients receive the most appropriate care at the most… more
- Mount Sinai Health System (New York, NY)
- …pharmacy group. 11.Obtains prior authorizations from intermediaries and payers, including managed care companies, insurance companies or others as appropriate. ... the Specialty Pharmacy Clinical Liaison, the Specialty Pharmacy Access Coordinator Lead supervises Financial Access Coordinator staff and interacts with clinical… more
- Elevance Health (New York, NY)
- …**Minimum** **Requirements:** + Requires BA/BS in Pharmacy. + Minimum of 2 years of managed care pharmacy (PBM) experience or residency in lieu of work ... Medicare and Commercial providers strongly preferred. + PBM or Managed Care experience highly desired. Unless expressly...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
- Grifols Shared Services North America, Inc (New York, NY)
- …connect them with the customer as appropriate + Possess an understanding of the Managed Care landscape and when to utilize necessary internal resources to assist ... and functions including Territory Sales Representatives, Regional Sales Directors, Managed Markets, the Product Brand Team and other necessary stakeholders.… more
- Molina Healthcare (New York, NY)
- …* 3 years' experience in Utilization/Quality Program Management * 2+ years HMO/ Managed Care experience * Experience demonstrating strong management and ... dependency services and assists with implementing integrated Behavioral Health care management programs. **Knowledge/Skills/Abilities** Provides Psychiatric leadership for utilization… more
- City of New York (New York, NY)
- …of public and commercial payors at the federal and state levels, and the evolution of managed care - Value-based care and Alternative Payment Models - Price ... and healthcare systems in partnership with community, faith-based, and health care organizations. CHECW's work focuses on social determinants of health, including… more
- Astellas Pharma (New York, NY)
- …Northeast** is responsible for planning, initiating, and managing profitable business relationships with Managed Care and Select Long Term Care customers in ... priority accounts are achieved + Establishes themselves as the strategic leader /subject matter expert for pull-through efforts; strategically and proactively leading… more
- Mount Sinai Health System (New York, NY)
- …+ Experience working in healthcare provider analytics related to revenue modeling, managed care contracting, population management, case management, clinical or ... others in the Data Science team and takes the lead role in project initiatives. **Qualifications** + BA or...higher preferred, in analytics development expertise, preferably in health care , or for a health provider, health plan or… more
- City of New York (New York, NY)
- …commercial payors at the federal and state levels, and the evolution of managed care . The regulation and financing of community-based organizations (CBO's) at ... and healthcare systems in partnership with community, faith-based, and health care organizations. CHECW's work focuses on social determinants of health, including… more
- Apicha Community Health Center (New York, NY)
- …collection and reporting of member enrollment and quality performance indicators with Managed Care Organization value-based initiatives and related reviews Data ... aims to improve community health by providing access to comprehensive primary care , preventive health services, mental health, and supportive services. The center is… more
- Catholic Health Services (Roslyn, NY)
- …in on-going educational activities related to clinical knowledge, professional issues and the managed care environment. Salary Range USD $66.55 - USD $90.00 /Hr. ... by US News & World Report as a national leader for Cardiology & Heart Surgery, as well as...in Geriatrics, Neurology & Neurosurgery, Orthopedics, and Pulmonology. Nursing care at St. Francis is also nationally recognized, with… more
- Pfizer (New York, NY)
- …thought leaders or high influence customers in hospitals, large group practices or managed care organizations. * A demonstrated track record of success and ... responsibilities, ranging from promoting Pfizer's product portfolio to health care providers and specialists, to educating members of the...and generous benefits and programs to help our colleagues lead healthy lives and to support each of life's… more
- City of New York (New York, NY)
- …State agencies (eg, SDOH, SOMH, OASAS, OPWDD), community health, mental health, and managed care organizations around psychiatric and other health services at ... of succeeding in permanent housing and independent living, improving access to care and health outcomes for low-income and vulnerable populations. The Office brings… more