- UNC Health Care (Morrisville, NC)
- …to execute such projects. The HCS Director of Managed Care Contracting will optimize the organization's contract performance with its contracted payers ... of the unique communities we serve. Summary: The HCS Director of Managed Care Contracting...negotiation, implementation, and management of: commercial fee-for-service and value-based managed care payer contracts ; Medicare… 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 ... and your career path. + Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs. **ARE YOU AN IDEAL… more
- Fresenius Medical Center (Waltham, MA)
- …**FINANCIAL/OPERATIONAL MANAGEMENT/BUSINESS PRACTICES:** + Oversee contract performance for managed care contracts , ensuring achievement of budget ... **Sr Director Managed Care and Payor... organizations. + Develops long-term strategies and tactics for managed care contract review and analysis.… 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)
- …financial metrics, identifying trends, variances, and areas for improvement. + Analyze managed care contracts for financial performance, identifying areas ... states of Idaho, Oregon, Utah and Arizona only.** The Director , Managed Care Analytics is...models, analyses and reports to support third party payer contract negotiations and optimization of the performance of existing… 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
- 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 ... - Friday | 8:00am - 5:00pm Job Summary: Responsible for analysis of contracts and performing contract negotiations to include monitoring and reviewing existing… 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
- BrightSpring Health Services (Englewood, CO)
- …Contract Administration and Payer Implementation functions as well as PBM contracting and Managed Care contracting. This is a highly visible position and will ... work closely with Directors of Managed Care , RCM, Sales Executive and Field...on payment rate and structure, and all aspects of contract language + Provides insight and knowledge in order… more
- Ventura County (Ventura, CA)
- …+ Experience managing contracts for products and services utilized in health care + Public sector contract management experience Recruitment Process To apply ... Director - HCA Contract Administration Print...contracts for products and services utilized in health care If you are interested, submit your resume and… more
- Ascendis Pharma (Princeton, NJ)
- …administration of rebate programs, including government rebates (eg, Medicaid, Medicare), managed care rebates, and commercial rebates. Ensure accurate ... skills. Ascendis Pharma is looking to hire an experienced Director , Market Access Contract Operations to join...processes accurately and before payment deadlines, oversee payments of managed care and government rebates, and manage… 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
- Molina Healthcare (Jackson, MS)
- …knit proximity ongoing after contract . * In conjunction with Director /Manager, Provider Contracts , negotiates Complex Provider contracts including ... Relationship Contracts . * Develops and maintains provider contracts in contract management software. * Targets...care environment. * 3+ years experience in provider contract negotiations in a managed healthcare setting… more
- Children's Hospital Los Angeles (Los Angeles, CA)
- …Medical Group leadership in working with Physician Organizations in the market regarding managed care contracts , strategies for improving market share and ... Summary:** This position is responsible for directing and coordinating the managed care policies, goals, and objectives related to contract language,… more
- Highmark Health (Pittsburgh, PA)
- …or related field **EXPERIENCE** **_Minimum:_** + 7 - 10 years' experience in managed care network development and provider relations/contracting management in a ... healthcare needs of plan members. Oversees development of provider contracts to ensure compliance with state specific requirements. **ESSENTIAL...healthcare and/or managed care environment + 7 - 10… more
- Molina Healthcare (St. Clair Shores, MI)
- …in health care field including, but not limited to, provider's office, managed care , or other health care field. **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS ... contracting with large specialty or multispecialty provider groups. * 1-3 Years Managed Care experience **PREFERRED EXPERIENCE** : Knowledge of integrated… 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
- Albany Medical Center (Albany, NY)
- …The Director is skilled at drafting, analyzing, and negotiating complex payer contracts . The Director develops contract proposals and leads in meetings, ... and engaging with internal and external stakeholders to optimize contracts or mediate issues requires the Director ...Demonstrated knowledge of current federal and NYS regulations regarding managed care contracting, as well as the… 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
- Morehouse School Of Medicine (Atlanta, GA)
- Sr. Director / Director , Department Administrator Bookmark this Posting Print Preview | Apply for this Job Please see Special Instructions for more details. ... of the health professional and scientific workforce; * Address primary health care through programs in education, research and service; With emphasis on people… more