- Tris Pharma (Monmouth Junction, NJ)
- …and other financial analysis. Perform analysis of sales, returns, Medicaid data, Managed Care data, chargebacks, wholesaler inventories & fees, voucher programs ... reconciliations, etc., to support department operations and analysis.ESSENTIAL FUNCTIONS Lead the Brand gross-to-net financial close process including but not… more
- Daiichi Sankyo, Inc. (Bernards, NJ)
- …creation and supply of innovative pharmaceutical therapies to improve standards of care and address diversified, unmet medical needs of people globally by leveraging ... across DS group including business units, functional units and corporate functions. Lead Training function team and Document and record management function team… more
- Daiichi Sankyo, Inc. (Bernards, NJ)
- …creation and supply of innovative pharmaceutical therapies to improve standards of care and address diversified, unmet medical needs of people globally by leveraging ... around rare diseases and immune disorders. Job Summary: Senior clinical operational leader accountable for operational planning and execution of FIH, clin pharm… more
- Daiichi Sankyo, Inc. (Bernards, NJ)
- …creation and supply of innovative pharmaceutical therapies to improve standards of care and address diversified, unmet medical needs of people globally by leveraging ... the ethical conduct of interventional, non-interventional, investigator-initiated trials and managed access programs to the highest quality standards. This position… more
- 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)
- …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
- Humana (Trenton, NJ)
- …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs… 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
- 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
- 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
- Humana (Trenton, NJ)
- …and populations served in target growth markets. Candidates will possess Medicaid managed care operations expertise and have experience in designing solutions ... us put health first** The Market Entry Capture Strategy Lead will lead initiatives to develop and...+ 5+ years' experience in a Medicaid or Medicare Managed Care Organization + 5+ years' experience… 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
- Cardinal Health (Trenton, NJ)
- … leader responsible for leading all aspects of Navista's Physician Office's revenue cycle, managed care and value based care programs and services. Key ... developing team members, and innovation + Develops and implements managed care contracting strategy including implementation of...with the payer, provider, and service partners to enhance care delivery and provider support. + Lead … more
- Humana (Trenton, NJ)
- …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs… more
- Humana (Trenton, NJ)
- …services (such as inpatient rehabilitation). **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs… 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
- Humana (Trenton, NJ)
- …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized at the Inpatient… more
- Humana (Trenton, NJ)
- …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... + MD or DO degree + 5+ years of direct clinical patient care experience post residency or fellowship, which preferably includes some experience in an… more
