- MASONICARE (Rocky Hill, CT)
- RN Director Assisted Living Masonicare at Greenridge Place - Rocky Hill, CT Full Time Salaried/Exempt / On-Call Rotation Summary of Position The ALSA Director is ... coordinating and managing all aspects of nursing and personal care services provided by ALSA staff to residents of...assisted living facility. Works closely with staff of the managed residential community and other Masonicare affiliates to ensure… more
- Fresenius Medical Center (Waltham, MA)
- **Sr Director Managed Care and Payor Strategy** **PURPOSE AND SCOPE:** The Senior Director of Managed Care & Payor Strategy is a strategic leader ... responsible for driving initiatives that strengthen relationships with Managed Care Payor Organizations and optimize contractual performance. This role leads a… more
- Huron Consulting Group (Chicago, IL)
- …power of collaboration, Huron offers a rewarding path forward. As the Healthcare Consulting Senior Director - Managed Care & Payment Strategy, you will: + ... design, ACO development (eg, MSSP, ACO REACH, Commercial shared risks), Medicaid managed care participation. Experience with population health initiatives such… more
- St. Luke's Health System (Boise, ID)
- …can be remote from the states of Idaho, Oregon, Utah and Arizona only.** The Director , Managed Care Analytics is responsible for the creation and development ... financial metrics, identifying trends, variances, and areas for improvement. + Analyze managed care contracts for financial performance, identifying areas for… more
- UNC Health Care (Morrisville, NC)
- …to improve the health and well-being of the unique communities we serve. Summary: The HCS Director of Managed Care Contracting serves as one of the Health ... efforts to develop plants to execute such projects. The HCS Director of Managed Care Contracting will optimize the organization's contract performance… more
- Dignity Health (Bakersfield, CA)
- …teams, and resolving provider issues. The role ensures consistent provider interactions with Managed Care operations and plays a vital part in new business ... also provide backup support for utilization management activities. The Director ensures care solutions align with best...years experience practicing medicine as a physician within a managed care setting - Minimum 5 years… more
- Fresenius Medical Center (Dallas, TX)
- … programs (HMOs, PPOs, POS, etc). Oversees Division's contractual relationships with managed care organizations and other third party payors regarding rate ... financial effect, cost benefit and utilization. + Negotiates contractual relationships with managed care organizations and other third party payors as needed.… more
- Sedgwick (Helena, MT)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Managed Care Client Service Director (REMOTE) Are you looking for an ... path. + Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs....including two (2) years in a supervisory capacity. **TAKING CARE OF YOU** + Flexible work schedule. + Referral… more
- Molina Healthcare (AZ)
- …including clinical practice in behavioral health and at least 3 years as a medical director in a managed care setting supporting utilization management and ... programs, utilization management standardization, and cost-effective quality outcomes in a managed care environment. Contributes to overarching strategy to… more
- Molina Healthcare (Chandler, AZ)
- …including clinical practice experience, and at least 2 years as a medical director in managed care organization supporting utilization management/quality ... leadership to the health plan in the development and execution of care management and utilization management programs. Develops clinical practice guidelines and… more
- BlackRock (New York, NY)
- …We are seeking a **Principal Engineer** to join our Platform Engineering Cloud Managed Services team to help us design cloud platforms for mass adoption. The ... (eg containerization, serverless, advanced analytics) that could enhance our managed platform. Drive continuous improvement in deployment processes, reliability… more
- Omaha Children's Hospital (Omaha, NE)
- …and assist with various analysis to understand impact to the organization + Work with Director of Managed Care to aid in understanding of reimbursement ... our mission is to improve the life of every child through exceptional care , advocacy, research and education. As the state's only full-service pediatric healthcare… more
- WellSpan Health (York, PA)
- …root causes of underpayments and denials. + Manages special projects as assigned by the Director of Managed Care . + Seeks and assists with identifying ... performance improvement initiatives within the Payor Contracting department to improve efficiency. + Maintains various contract management systems in collaboration with the Revenue Management and Information Technology departments. **Common Expectations:** +… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- Position is On-Site The Behavioral Health Nurse - Managed Care is responsible for coordinating, monitoring, and delivering behavioral health services within a ... managed care environment. This role involves working...criteria for medical necessity for the requested level of care /patient status to the Medical Director . +… more
- Abbott House (Bronx, NY)
- Job Summary: The Medicaid Managed Care Liaison is the primary contact person for the Medicaid Managed Care Plans (MMCP). MMC Liaison must have ... requirements + The unique complex needs of the foster care population + Medicaid Managed Care...+ Perform other secretarial duties as requested by Medical Director . + Any other related duties as required Educational… more
- InGenesis (Columbia, SC)
- InGenesis is currently seeking a Registered Nurse / RN - Managed Care Coordinator to work for our client located in Columbia, SC. In this role you will review ... (Medical Director , Case Manager, Preventive Services, Subrogation, Quality of care Referrals, etc.). * Participate in data collection/input into system for… more
- Saint Francis Health System (Tulsa, OK)
- …performs on going analysis, which maintains the integrity of financial expectations of managed care contracts within the Epic system. Resolves programming issues ... other healthcare professionals and staff. Works frequently with individuals at Director level or above. Special Job Dimensions: None. Supplemental Information: This… more
- Huron Consulting Group (Chicago, IL)
- …our team as the expert you are now and create your future. The Huron Managed Services Coding Operations Director oversees a portfolio of clients and is ... Management, Culture, Staff Engagement, Training and Solution Development. The Huron Managed Services Coding Operations Director leads the operations management… more
- Ventura County (Ventura, CA)
- …the current principles and techniques of diagnosis and treatment + Experience with managed care + Experience and current knowledge of Quality Assurance, ... Medical Director , Ventura County Health Care Plan...of Medicine and includes the following: + Experience with managed care + Experience and current knowledge… more
- Henry Ford Health System (Troy, MI)
- …relevant management experience in health care organizations, preferably relating to managed care . + Demonstrated commitment and understanding of managed ... pertinent to the assurance of high quality of health care , effectiveness and efficiency. The Medical Director ... care . + Demonstrated managed care knowledge including a strong knowledge base of utilization,… more
