- 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 (Madison, 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
- Teva Pharmaceuticals (Parsippany, NJ)
- Associate Director, Managed Care Payer Analytics (V&A) Date: Jun 4, 2025 Location: Parsippany, United States, New Jersey, 07054 Company: Teva Pharmaceuticals Job ... make a difference with. **The opportunity** The Associate Director, Managed Care Payer Analytics is responsible for...be included in other related duties or assignments. + Lead the development and evaluation of pre and post-deal… more
- Teva Pharmaceuticals (Parsippany, NJ)
- Director, Managed Care Payer Contracting (V&A) Date: Jun 4, 2025 Location: Parsippany, United States, New Jersey, 07054 Company: Teva Pharmaceuticals Job Id: ... to make a difference with. **The opportunity** The Director, Managed Care Payer Contracting is a key...be included in other related duties or assignments. + Lead the creation, revision, and management of all payer… 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
- Elevance Health (Newark, NJ)
- …experience and requires a minimum of 2 years clinical, utilization review, or managed care experience; or any combination of education and experience, which ... Management (or care management) experience in a managed care setting is highly preferred. +...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… 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 ... State RN 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
- 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
- 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
- Sanofi Group (Newark, NJ)
- …their assigned accounts. Efforts will include working with national headquarters of managed care organizations and leading pull-through strategies to local ... The Regional Account Director reports to the Regional Accounts Leader and is responsible for establishing and leveraging credible...as well as initiatives with other large and local managed care organizations. The Regional Account Director… 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
- Sanofi Group (Morristown, NJ)
- … a team responsible for negotiating contractual language with national and regional managed care customers and conducting analytics for select regional accounts. ... Medicaid, and Commercial GPO/PBM agreements, while leveraging expert understanding of managed care contract components including definitions, payment terms,… 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
- Prime Healthcare (Denville, NJ)
- …Billing is the lead responsible for the timely follow-up of Managed Care /Commercial accounts. Communicates clearly and efficiently by phone with health ... and reports. Responsible to obtain State collection guidelines if applicable. Reviews managed care contracts. #LI-BM2 Qualifications + Minimum of four years… more
- Prime Healthcare (Denville, NJ)
- …Resolution is the lead responsible for the timely follow-up of Managed Care /Commercial accounts. Communicates clearly and efficiently by phone with health ... reports. Responsible to obtain State collection guidelines if applicable. Reviews managed care contracts. #LI-BM2 Qualifications EDUCATION, EXPERIENCE, TRAINING… 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
- Molina Healthcare (Yonkers, NY)
- …state priorities, competitive dynamics, and the latest Medicaid trends, positioning Molina as a leader in Medicaid managed care + Track regulatory compliance ... in market strategy, business development, or healthcare consulting, specifically within Medicaid managed care or equivalent related field + Proven experience in… more