• Neighborhood Health Plan of Rhode Island (Smithfield, RI)
    …field in lieu of a degree Minimum of five (5) years' experience with a managed care organization or a health care related organization (HMO; ... Category Professional / Experienced Description The Policy and Claims Research Specialist is responsible for supporting the Payment Integrity initiatives and… more
    Upward (07/31/25)
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  • Managed Care Contract Support…

    Publix (Lakeland, FL)
    Care Contract Support Specialist serves as the subject-matter expert in the contracting process for the Managed Care Contracting Team in the ... **34227BR** **Position Title:** Managed Care Contract Support Specialist...The Managed Care Contract Support Specialist is responsible for optimizing the contracting more
    Publix (08/30/25)
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  • Contract Specialist Lead

    Corewell Health (Grand Rapids, MI)
    …complex internal and external customers. The successful candidate will understand the nuances of managed care contracting , analytics, managed care ... Committee meetings. May be requested to present and represent Managed Care Contracting updates/initiatives at meeting with internal/external constituencies.… more
    Corewell Health (06/19/25)
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  • Specialist , Provider Contracts HP…

    Molina Healthcare (Cincinnati, OH)
    …in the health care field including, but not limited to, provider's office, managed care organization, or other health care field. **PREFERRED EDUCATION** ... or an equivalent combination of education and experience **PREFERRED EXPERIENCE** : 1-3 Years Managed Care experience To all current Molina employees: If you are… more
    Molina Healthcare (08/24/25)
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  • Senior Revenue Cycle Specialist

    Stony Brook University (East Setauket, NY)
    …and denied accounts. + Collaborates on denials prevention initiatives. + Liaises with Managed Care Contracting and Insurance Company Provider Representatives ... Senior Revenue Cycle Specialist **Position Summary:** At Stony Brook Medicine, the...Hospital Revenue Cycle or Patient Accounting Department resolving hospital Managed Care payment variances and/or denials. **Job… more
    Stony Brook University (08/08/25)
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  • Senior Denials Mgmt Specialist

    Houston Methodist (Sugar Land, TX)
    …+ Maintains knowledge of Federal, State, and local billing regulations and partners with managed care contracting as needed. + Maintains knowledge of ... determinations and, denial reason and trending as appropriate, Monitors CMS, managed care and payor communications for updates/alerts/releases and functions… more
    Houston Methodist (07/31/25)
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  • Full Time Verification Specialist - PMPH…

    Penn Medicine (Plainsboro, NJ)
    …significant knowledge of all types in-network and out-of-network health insurance, managed care companies, benefits and policies for commercial, Medicare ... you living your life's work? **Job:** Full Time Verification Specialist **Location:** PMPH Specialist Staff - Medical...+ Ability to develop a good working relationship with managed care organizations, and provide excellent customer… more
    Penn Medicine (08/07/25)
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  • Payer Relations Specialist

    Waystar (Atlanta, GA)
    …Develop and maintain strong relationships with payers, including health insurance companies, managed care organizations, and government agencies. + Create new, ... **ABOUT THIS POSITION** The Payer Relations Specialist is responsible for initiatives to identify and...performance. + Track and communicate the status of payer contracting and connections activities ​ **OPTIONAL DETAILS --Looking for… more
    Waystar (06/30/25)
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  • Senior Specialist , Government Contracts

    Molina Healthcare (Rockford, IL)
    …will have the following experience-** + Live in Illinois and are familiar with Managed Care in Illinois and how HHF operates. + Background/experience in business ... Molina Healthcare is hiring a Sr Specialist in our Government Contracts department. This role...field. **Required Experience** + 3 years' experience in a managed care environment. + Experience demonstrates strong:… more
    Molina Healthcare (09/16/25)
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  • Training Governance Specialist

    Carnival Cruise Line (Miami, FL)
    …Effectively coordinate and collaborate with stakeholders to ensure ownership and contracting is deliberately/consciously managed and applied. + Measuring and ... something for everyone. We are looking for an amazing Specialist , Training Governance to fill this role, which is...targets are met and that corporate reporting requirements are managed . + Responsible for all governance group preparation and… more
    Carnival Cruise Line (08/10/25)
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  • Contract Specialist

    Gentiva (Atlanta, GA)
    …andbe responsible for preparing, reviewing, analyzing, and responding to requests for managed care , provider, and other related healthcare agreements. + Prepares ... **Overview** We're looking for a **Contract Specialist ** to join our team.You will report directly...and negotiates agreements with contracting agencies/payors. + Consults frequently with operations in the… more
    Gentiva (08/15/25)
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  • Sr. Specialist -Pharmacy Contracts - Sharp…

    Sharp HealthCare (San Diego, CA)
    …the system. **Required Qualifications** + 3 Years experience in a hospital, ambulatory care and/or managed care pharmacy environment. + California Pharmacist ... Pharmacy -REQUIRED **Preferred Qualifications** + 3 Years experience with managed care , PBM and/or Medicare Part D,...to drug reimbursement and net revenue, across all ambulatory care settings.Assists Contract's team with DOFR contracting more
    Sharp HealthCare (07/27/25)
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  • Sales Outreach Specialist

    Cedars-Sinai (CA)
    …a dynamic, inclusive environment that fuels innovation and the gold standard of patient care we strive for. **What will you be doing:** The Sales Outreach ... Specialist is responsible for successfully promoting the use of...and provides strong customer service resulting in increased specialty care referrals to Cedars-Sinai Medical Center (CSMC). The incumbent… more
    Cedars-Sinai (07/19/25)
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  • Clinical Denials Specialist

    UHS (Binghamton, NY)
    …healthcare system, one connection at a time. Primary Department, Division, or Unit: UHS Managed Care Contracting Primary Work Shift: Day Regular Scheduled ... (UHS) is seeking a proactive and analytical Clinical Denials Specialist to join our Revenue Cycle team. In this...clinical staff to prevent future issues, and ensuring that care delivered is care reimbursed. Join us… more
    UHS (09/09/25)
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  • Procurement Specialist (Charlotte, NC)

    Compass Group, North America (Charlotte, NC)
    …the world's largest contract food and support services provider. **Why Foodbuy?** We care about our associates, our clients, and our community. We think big, ... clients, business partners and fellow associates. **Job Summary** The **Procurement Specialist ** role sits in out our Termset Management, Operations Department and… more
    Compass Group, North America (08/22/25)
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  • Inventory Management Specialist

    Veterans Affairs, Veterans Health Administration (Temple, TX)
    Summary This position serves as an Operating Room Inventory Manager Specialist in the Commodity Management Division with specialized focus on the Medical/Surgical ... of the Logistics Service in a Veteran Affairs Health Care System (VA HCS) and supported catchment area, with...to all surgery service, prosthetics, nursing and SPS. Inventories managed include a wide variety of OR expendable items… more
    Veterans Affairs, Veterans Health Administration (09/11/25)
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  • Financial Management Unit Specialist

    Helio Health Inc. (Syracuse, NY)
    …Guidelines. + Coordinates services with external case managers, managed care operators, licensing, funding, and contracting agencies. + Provide excellent ... support the mission of Helio Health, Inc., theFinancial Management Unit Specialist (Representative Payee) is responsible for the day-to-day interaction with patients… more
    Helio Health Inc. (08/13/25)
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  • Senior Specialist , Provider Network…

    Molina Healthcare (Cleveland, OH)
    …or equivalent combination of education and experience **Required Experience** + 3-5 years managed care experience, including 2+ years in Provider Claims and/or ... level (or higher) **Preferred Education** Bachelor's Degree **Preferred Experience** + 5+ years managed care experience + QNXT; SQL experience + Crystal Reports… more
    Molina Healthcare (08/02/25)
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  • Provider Relations & Communications…

    Queen's Health System (Honolulu, HI)
    …Microsoft Office applications (ie Outlook, Word, Excel, PowerPoint). * Knowledge of managed care and healthcare operations preferred. * Prior experience working ... and purchasers (value base contracting ) preferred. * Prior project management experience in health care preferred. Equal Opportunity Employer/Disability/Vet more
    Queen's Health System (09/09/25)
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  • Credentialing Specialist

    DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
    …required. Qualifications: + Minimum of two (2) years previous experience in a managed care organization's Credentialing department. + NAMSS CPCS certification is ... for completeness and requesting missing data from the practitioner offices and/or Contracting Department staff; + Creating a new electronic record in the… more
    DOCTORS HEALTHCARE PLANS, INC. (09/14/25)
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