- 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
- Bristol Myers Squibb (Princeton, NJ)
- …for strategic and functional leadership of a team responsible for accurate and timely Managed Care Commercial and Medicare Part D rebate processing and payments, ... as all aspects with evaluating implications of and reporting Managed Care data required for US and...Care rebate systems (REACT$ and vendor interfaces) + Lead and assist with special projects as required (IRA,… more
- Bristol Myers Squibb (Princeton, NJ)
- …and government pricing calculation + Lead the monthly and quarterly Managed Care processes that support government pricing calculations + Collaborate with ... leadership of a team responsible for accurate and timely Managed Care Commercial and Medicare Part D...Care rebate systems (REACT$ and vendor interfaces) + Lead and assist with special projects as required (IRA,… more
- Erickson Living (Tinton Falls, NJ)
- …informational and developmental meetings to include Medicare and Medicaid coverage changes, Managed Care information, and other pertinent information for family ... Seabrook Village by Erickson Senior Living Seabrook is seeking a strong sales leader who will be responsible for developing and maintaining maximum census in… more
- Hackensack Meridian Health (Edison, NJ)
- …applicable. + Write Care Plans in EPIC Healthy Planet for high-risk patients being care managed . + Other duties and/or projects as assigned. + Adheres to HMH ... our mission to transform healthcare and serve as a leader of positive change. The ** Care Coordinator...Registered Nursing Program. + Minimum 2-3 years experience in managed care or health education/coaching is preferred.… more
- Elevance Health (New York, NY)
- …experience and requires a minimum of 2 years clinical, utilization review, or managed care experience; or any combination of education and experience, which ... Management (or care management) experience in a managed care setting is highly preferred. +...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… 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 ... State RN License.** **Position Purpose:** Assesses, plans, and implements complex care management activities based on member activities to enable quality,… more
- Hackensack Meridian Health (Edison, NJ)
- …(BSN) or 1 year experience for non BSN HackensackUMC employees. + Knowledge of managed care principles. + Knowledge of Quality Improvement Program - New Jersey ... our mission to transform healthcare and serve as a leader of positive change. The **Nurse Navigator, Transitions of... of positive change. The **Nurse Navigator, Transitions of Care ** is a member of the healthcare team and… 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
- Dr. Reddy's Laboratories (Princeton, NJ)
- …contracting dynamics in the Buy & Bill Biologics space. Strong expertise in managed care landscape across medical and pharmacy benefit, commercial and government ... unmet medical needs, we are dedicated to helping people lead longer and healthier lives. We are seeking dynamic...+ Monitor key external trends in the areas of managed care , reimbursement and other healthcare policies… 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
- Sanofi Group (New York, NY)
- …their assigned accounts. Efforts will include working with national headquarters of managed care organizations and leading pull-through strategies to local ... The Regional Account Director reports to the Regional Accounts Leader and is responsible for establishing and leveraging credible...as well as initiatives with other large and local managed care organizations. The Regional Account Director… 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
- Elevance Health (Woodbridge, NJ)
- …process and the ability to interpret and apply member contracts, member benefits, and managed care products are strongly preferred. + Prior managed ... foundation upon which we are creating greater access to care for our members, greater value for our customers,...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… 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
- Daiichi Sankyo Inc. (Basking Ridge, NJ)
- …G2N Contract Forecasting to ensure support of cross-functional teams regarding key managed care accounts and ASP analysis. This includes: profitability analysis ... the Senior Director, Forecasting & Business Analytics is to lead the forecasting and financial and analytical support of...knowledge; preferred + Detailed knowledge of all channels of managed care environment in the US (commercial,… 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
- Amneal Pharmaceuticals (Bridgewater, NJ)
- …to influence decision making that creates formulary access and approval. Conduct additional managed care marketing and trade focused activities to support broad ... Pharmacy benefit formularies, across all lines of business (Commercial, Medicare, & Managed Medicaid), as well as monitoring and supporting access across these… more