- 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)
- …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 (Hempstead, 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
- 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
- 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
- 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
- Actalent (Bronx, NY)
- …+ Certified Professional Coder certification is a plus. + Experience within a healthcare or managed care setting preferred. + Knowledge of Managed Long Term ... to close on Jun 19, 2025. About Actalent Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies… more
- City of New York (New York, NY)
- …of public and commercial payors at the federal and state levels, and the evolution of managed care - Value-based care and Alternative Payment Models - Price ... and healthcare systems in partnership with community, faith-based, and health care organizations. CHECW's work focuses on social determinants of health, including… more
- Astellas Pharma (New York, NY)
- …Northeast** is responsible for planning, initiating, and managing profitable business relationships with Managed Care and Select Long Term Care customers in ... priority accounts are achieved + Establishes themselves as the strategic leader /subject matter expert for pull-through efforts; strategically and proactively leading… more
- Hackensack Meridian Health (Hackensack, NJ)
- …of discharge planning, utilization management, case management, performance improvement, and managed care reimbursement. + Understanding of pre-acute and ... our mission to transform healthcare and serve as a leader of positive change. The **Alternate Rate RN Case...RN Case Manager** bears overall responsibility for coordinating patient care activities to ensure that care meets… more
- Mount Sinai Health System (New York, NY)
- …+ Experience working in healthcare provider analytics related to revenue modeling, managed care contracting, population management, case management, clinical or ... others in the Data Science team and takes the lead role in project initiatives. **Qualifications** + BA or...higher preferred, in analytics development expertise, preferably in health care , or for a health provider, health plan or… more