- 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
- 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
- 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
- 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
- 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
- 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
- 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 (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
- 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
- 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
- Centene Corporation (Queens, NY)
- …partners **Education/Experience:** Bachelors Degree Required. MBA/MHA/MPH Preferred. 2-5 years of relevant managed care experience including at least 1 year of ... to partially offset the Education/Experience described above. 5-7 years of experience in managed care or healthcare consulting with a focus on Medicare Advantage… 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
- 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
- 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
- Elevance Health (New York, NY)
- …**Minimum** **Requirements:** + Requires BA/BS in Pharmacy. + Minimum of 2 years of managed care pharmacy (PBM) experience or residency in lieu of work ... Medicare and Commercial providers strongly preferred. + PBM or Managed Care experience highly desired. Unless expressly...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… 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
- Molina Healthcare (New York, NY)
- …* 3 years' experience in Utilization/Quality Program Management * 2+ years HMO/ Managed Care experience * Experience demonstrating strong management and ... dependency services and assists with implementing integrated Behavioral Health care management programs. **Knowledge/Skills/Abilities** Provides Psychiatric leadership for utilization… more
- Molina Healthcare (Yonkers, NY)
- …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 + Crystal Reports for data… more