• Merck & Co. (Rahway, NJ)
    …meta-analyses, and economic modelling. Key responsibilities also include development of American Managed Care Pharmacy (AMCP) dossiers for US payers, and Global ... and standards, including Good Pharmacoepidemiology Practice (GPP) for applicable work.-Develops American Managed Care Pharmacy (AMCP) dossiers for US payers, and… more
    HireLifeScience (05/30/25)
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  • Managed Care Leader

    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
    WTW (03/26/25)
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  • Continuing Care Sales Leader

    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
    Erickson Living (05/13/25)
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  • Care Coordinator, Registered Nurse (RN)…

    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
    Hackensack Meridian Health (05/09/25)
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  • Billing & Collections Specialist

    Ultimate Care Inc (Brooklyn, NY)
    …will be responsible for managing the billing and collections process for Medicare/Medicaid Managed Care claims. You will work closely with our finance and ... independently and meet deadlines + Experience with billing Medicaid Managed Care plans is a plus We...Hampshire, New Jersey & Pennsylvania. We offer comprehensive home care services where we lead with our… more
    Ultimate Care Inc (05/31/25)
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  • Senior Care Manager (RN)

    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
    Centene Corporation (06/01/25)
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  • Health Homes Care Manager

    Graham Windham (Bronx, NY)
    …necessary documents for monthly care management billing to Health Home/ Managed Care Organization. Position Qualifications: + Bachelor's degree in health ... Health Homes Care Manager, Bronx Job Details Job Location 1946...to create and implement innovative strategies so everyone can lead healthy, joyful, and successful lives. Principal Objective/Role Overview:… more
    Graham Windham (03/17/25)
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  • Nurse Navigator - Transitions of Care

    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
    Hackensack Meridian Health (05/02/25)
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  • Family Care Coordination Assistant Director

    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 (05/14/25)
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  • Healthcare Payment & Financing Innovation Senior…

    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
    City of New York (05/25/25)
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  • Senior Contracting Compliance Analyst…

    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
    Mount Sinai Health System (04/09/25)
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  • AVP, Regional Sales - New York Health Plan

    Molina Healthcare (Yonkers, NY)
    …the right care at the right time. The department strives to deliver managed care benefit plans in accordance with CMS's and regulator's high expectations ... in New York. **Knowledge/Skills/Abilities** * Top sales professional within a multi-state managed care organization * Responsible for setting sales strategy,… more
    Molina Healthcare (05/31/25)
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  • Medical Director (Marketplace)

    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
    Molina Healthcare (06/06/25)
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  • Health Benefit Rep - Queens (Korean)

    Centene Corporation (Queens, NY)
    …including "metal" products offered through the New York State of Health (NYSOH), Medicaid Managed Care , Child Health Plus, Medicare, MLTC, FIDA and HARP. Ability ... the Sales Force CRM as an activity tracking and lead /referral tracking tool, to manage appointments and follow up,...GED, required. 2 to 5 years prior experience in managed care , sales, customer service or related… more
    Centene Corporation (05/09/25)
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  • National Account Director - Market Access

    IQVIA (Newark, NJ)
    …and clients. RESPONSIBILITIES . Execute the effective launch of new drugs in Managed Care accounts, PBMs, Medicaid PBMs, and State Government Accounts by ... national and regional accounts, under the direction of the project's Client Lead . This includes developing contracts to optimize plan access, creating and following… more
    IQVIA (05/31/25)
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  • Specialty Pharmacy Financial Access Coordinator,…

    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
    Mount Sinai Health System (06/10/25)
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  • Community Relations Specialist - Bilingual

    Centene Corporation (Queens, NY)
    …sales/marketing experience, preferably with government products. required Health insurance or managed care experience preferred Specific language skills may be ... three years sales/marketing experience, preferably with government products. Health insurance or managed care experience a plus. Driver's License may be required… more
    Centene Corporation (05/31/25)
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  • Healthcare & Life Sciences Industry Vertical…

    WTW (Short Hills, NJ)
    …including producers, client advocates, broking teams, and sub-segment leaders (Life Sciences, Managed Care & Senior Living) + Actively participate on both ... Role** The Healthcare and Life Sciences (HC&LS) Industry Vertical leader is highly-collaborative and provides both the strategic vision...evolve the business, + Participate in sales calls and lead the delivery of the value propositions, + Educate… more
    WTW (03/26/25)
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  • Associate Director, Outcomes Research

    Merck (Rahway, NJ)
    …meta-analyses, and economic modelling. Key responsibilities also include development of American Managed Care Pharmacy (AMCP) dossiers for US payers, and Global ... including Good Pharmacoepidemiology Practice (GPP) for applicable work. + Develops American Managed Care Pharmacy (AMCP) dossiers for US payers, and Global… more
    Merck (05/30/25)
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  • Key Account Manager - East

    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
    Grifols Shared Services North America, Inc (06/06/25)
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