- Novo Nordisk Inc. (Plainsboro, NJ)
- …position is part of the business assurance function for Commercial, Part D, & Managed Care contracts. This role is responsible for ensuring the validation of ... assurance initiatives including but not limited to utilization management controls, 340B compliance , and contract compliance . Relationships This individual… more
- Daiichi Sankyo, Inc. (Basking Ridge, NJ)
- …can be managed appropriately.Provide oversight of the CRO to ensure compliance with Daiichi Sankyo's quality measures. Leads the creation of the Risk ... creation and supply of innovative pharmaceutical therapies to improve standards of care and address diversified, unmet medical needs of people globally by leveraging… more
- Benchmark Human Services (Boise, ID)
- …Response Team. Work with MRT staff, 988 Managing Entity, IDHW, Behavioral Health Managed Care Organization (BHMCO) and other stakeholders to discover ways to ... provide leadership and supervision of mobile crisis response services to ensure compliance with federal and state regulations, corporate policies and procedures and… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …Safety Department7A Designs and oversees programs managed by the Environment of Care Coordinator that ensure compliance with DNV, NFPA, OSHA, FDA, EPA and ... oversees a comprehensive regulatory program designed to achieve DNV accreditation, and compliance with many other regulatory agencies to include GAEPD, DCH, CMS, DOT… more
- Select Medical (Westlake Village, CA)
- …Plan with Company Match Paid Time Off , Sick Time, and Holidays Markets Managed Locally Flexible Spending Accounts Employee Discounts and perks on good and services ... maintain all corporate & clinical services required training and maintain compliance with state/local/federal regulations. Evaluate, treat, and direct treatment for… more
- Marion County (Salem, OR)
- …monitoring, per the PSRB's policies and procedures, to ensure individuals are in compliance with their conditional release orders and able to be safety managed ... with community partners, including the PSRB, I/DD Services, PTCN, licensed care providers, and other entities that provide services to individuals served… more
- e CancerCare (Nashville, TN)
- …in reports, which includes determining the impact of adjustments to managed care reimbursement terms and/or contract compliance , along with rate modeling ... setting. Strong communication skills are necessary. . Years of Experience: 1-2 in Managed Care + contract negotiating experience with managed care… more
- State of Indiana (Indianapolis, IN)
- …Supports programs. You will serve as a subject matter expert on managed care programs and contract compliance within the Indiana Health Coverage Programs ... contract compliance liaison with the executive staff of the managed care entities (MCEs), assigned contract vendors, and act on behalf of FSSA… more
- University of Miami (Medley, FL)
- …staff to resolve issues related to the revenue stream. + Analyzes and monitors payer trends, managed care contract compliance , contract and payer ... analysis of reimbursement for all payers, and develops recommendations for optimal managed care reimbursement. The Revenue Cycle Payer Relations Analyst will… more
- UNC Health Care (Morrisville, NC)
- …initiatives and business opportunity assessment with administrative and clinical leadership. Ensures managed care payer compliance . Leads the establishment ... the unique communities we serve. **Job Summary:** The System Executive Director - Managed Care position is responsible for planning, directing and coordinating… more
- Banner Health (AZ)
- …and innovative employment options by offering remote and hybrid work settings. As a Managed Care Contract Consultant with Banner Plans & Networks, you ... and revise proposed contracts and other related documents, ensuring compliance with company policy/guidelines and legal and regulatory requirements...assignments in Managed Care , specific managed care contract experience is… more
- AdventHealth (Altamonte Springs, FL)
- …value you'll bring to the team:** . Provide documentation to internal departments on managed care contract requirements and changes including but not limited ... to attend to meetings** **The role you'll contribute:** The Managed Care Coordinator is a responsible member...kept to a minimum. . Monitor payors to ensure compliance with the contract 's financial language provisions.… more
- Prime Healthcare (Denville, NJ)
- …Responsibilities Regional Manager, Managed Care is responsible for managed care contract management and payer relations. The Regional ... care infrastructure; assist in the measurement of payer compliance with contract terms; JOC management; and...or relevant bachelor's degree2. Minimum of 3 years of contract negotiation/ managed care experience at… more
- Sea Mar Community Health Centers (Vancouver, WA)
- …the following position: Sea Mar is a mandatory COVID-19 and flu vaccine organization Managed Care Regional Coordinator - Posting #25771 Hourly Rate: $27.88 to ... $31.49 Position Summary: Full-time Managed Care Regional Coordinator position available in...periodic staff competency testing and site audits to ensure compliance with corporate and departmental policies, standards and maintain… more
- Prime Healthcare (Lynwood, CA)
- …of accounts in accordance with the specific payer guidelines, policies, procedures, and compliance regulations for managed care . This includes maintaining ... Human Resources. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC\_KnowYourRights\_screen\_reader\_10\_20.pdf Responsibilities The Senior Managed Care Biller/Collector is responsible for both… more
- Molina Healthcare (Las Vegas, NV)
- **Molina Healthcare of Nevada** is hiring for a ** Managed Care , Gov Contracts Sr. Specialist** . This role can be worked remotely from anywhere in the state of ... Will Have The Following Experience:** + Reading, interpreting, and responding to Managed Care regulatory bodies and contracts. + Project Management experience… more
- Robert Half Legal (Rancho Cucamonga, CA)
- …Large Healthcare Organization! You will be joining a large legal team and a Managed Care expert (Medical, Medicaid, Covered CA). You will manage outside counsel ... for discovery and litigation, advise on regulatory and compliance issues, and HIPAA advisor. This Counsel is onsite...Ability to commute to Inland Empire 3 days/week + Managed care experience + Litigation experience in… more
- Teva Pharmaceuticals (Parsippany, NJ)
- …(PDL) to validate product placement complies with all terms and conditions of the managed care contract . Using critical thinking skills and data analytics, ... Sr. Contract Compliance Analyst III Date: Apr...Sr. Contract Compliance Analyst III Date: Apr 17, 2024 Location:...resolve compliance and eligibility issues with contracted managed care customers. This position works with… more
- Queen's Health System (Honolulu, HI)
- …provided to members. * Performs financial analysis, operational evaluation, and compliance issues on payer agreements to recommend action for executive review. ... negotiate optimal contractual agreements. * Responsible for maintenance of contract modules. * Serves as a liaison with selected...LICENSURE: * Bachelor's degree in Business, Finance or Health Care Administration or four (4) years with health … more
- 3M (Maplewood, MN)
- …management of outsource testing for environmental and industrial hygiene samples at contract testing laboratories to meet regulatory and compliance requirements. ... Job Description: Project Manager - Managed Lab Outsource (Hybrid; Maplewood, MN) Collaborate with Innovative 3Mers Around the World Choosing where to start and grow… more
