- 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
- Bristol Myers Squibb (Princeton, NJ)
- …and government pricing calculation + Lead the monthly and quarterly Managed Care processes that support government pricing calculations + Collaborate with ... leadership of a team responsible for accurate and timely Managed Care Commercial and Medicare Part D...Care rebate systems (REACT$ and vendor interfaces) + Lead and assist with special projects as required (IRA,… more
- 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
- Humana (Trenton, NJ)
- …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs… more
- 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
- Atlantic Health System (Morristown, NJ)
- …participation and transitions of care . + Knowledge /implementation of payer / managed care systems. + Knowledge/implementation of budget and department fiscal ... System aims to deliver the highest quality, safety and care combined the best experience for our patients and...environment that promotes competency . In this role, this leader will ensure optimal patient input, work to reduce… 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
- 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
- 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
- Humana (Trenton, NJ)
- …and populations served in target growth markets. Candidates will possess Medicaid managed care operations expertise and have experience in designing solutions ... us put health first** The Market Entry Capture Strategy Lead will lead initiatives to develop and...+ 5+ years' experience in a Medicaid or Medicare Managed Care Organization + 5+ years' experience… more
- Dr. Reddy's Laboratories (Princeton, NJ)
- …contracting dynamics in the Buy & Bill Biologics space. Strong expertise in managed care landscape across medical and pharmacy benefit, commercial and government ... unmet medical needs, we are dedicated to helping people lead longer and healthier lives. We are seeking dynamic...+ Monitor key external trends in the areas of managed care , reimbursement and other healthcare policies… more
- Cardinal Health (Trenton, NJ)
- … leader responsible for leading all aspects of Navista's Physician Office's revenue cycle, managed care and value based care programs and services. Key ... developing team members, and innovation + Develops and implements managed care contracting strategy including implementation of...with the payer, provider, and service partners to enhance care delivery and provider support. + Lead … 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
- Humana (Trenton, NJ)
- …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs… more
- Humana (Trenton, NJ)
- …services (such as inpatient rehabilitation). **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs… more
- Humana (Trenton, NJ)
- …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized at the Inpatient… more
- Humana (Trenton, NJ)
- …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... + MD or DO degree + 5+ years of direct clinical patient care experience post residency or fellowship, which preferably includes some experience in an… more
- Zurich NA (Trenton, NJ)
- …profitability goals and ensure the delivery of quality, cost effective services to our Managed Care stakeholders. You will act as a subject matter expert and ... the AVP of Utilization Review & Pharmacy, you will lead and direct a team of Utilization Review and...technical resource to Managed Care stakeholders regarding operational and regulatory… more
- J&J Family of Companies (Titusville, NJ)
- …is required. + A minimum of four years of experience in Sales, Marketing, Managed Care , Account Management, Pricing, and/or related fields is required. + The ... big picture orientation with attention to detail. + Detailed knowledge of managed care organizations, payer types, coverage design, and procurement/distribution… more