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Create reports that analyze cost trends at the provider level and communicate recommendations to HNS teams, including Network Contracting and Care Management. Medical Economics ConsultantHealthCare Support is actively seeking a Medical Economics Consultant to fill an opening with one of the nation's largest managed care organizations.
$95,000Full-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Requires a demonstrated progressive understanding of managed care business processes, data, systems, and applications for claims payment, enrollment, benefit design, product pricing, network and provider contracting, and utilization management.
$93,000 - $127,050 a yearFull-timeExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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Experience working in healthcare provider analytics related to revenue modeling, managed care contracting, population management, case management, clinical or financial decision support required.
$86,000 - $165,000 a yearFull-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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3 to 5 years of experience in Managed Care Organization(s), Provider Relations and knowledge of provider contracting; or at least 5-8 years of experience in Sales and/or Account Management with demonstrated knowledge of managing and cultivating relationships with new contact and existing business partnerships.
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HMO/Managed care experience. Experience with NCQA, HEDIS, Medicaid, Medicare and Pharmacy benefit management, Group/IPA practice, capitation, HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment, disease management, and evidence-based guidelines.
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The Financial Specialist Sr. Managed Care Contracting oversees the data gathering financial modeling and creation of ad hoc financial reports using multiple database systems for the Managed Care department.
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Provides expert counsel regarding clinical operations and strategies for its growth and development and is responsible for the development, interpretation, coordination, and administration of policies on business and clinical operations, nursing, social work, hospital networks and managed care contracting Works collaboratively with local executive team to facilitate optimal integration and coordination of cancer services for outpatient and inpatient programmatic development.
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Works collaboratively with CEO, CFO, Operations, and Managed Care contracting to assess current and proposed lines of business. Supports business model forecasting, proposed partnership models, potential managed care relationships and informs CEO on key assumptions to ensure appropriate foundational and growth forecasts.
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Preserves pricing transparency strategy and CDM to ensure optimization of managed care contracting and revenue integrity managed. determine self-pay, and financial and charity care opportunities to minimize bad debt.
ExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Experience in a managed health care environment with exposure to provider contracting, servicing benefits interpretation, and internal operations of provider relations function required.
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Oversee quality control and quality assurance of Payer Analytics & Economics analytics deliverables and financial models to support the negotiation and implementation of appropriate reimbursement rates associated language, between physicians/hospitals and payers/networks for managed care contracting initiatives.
$62.51 - $90.64 an hourFull-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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Operations include the following areas: Budgeting, Cost Accounting, Clinical Resource Management, Financial Business Planning, and Managed Care Contracting. Operations include the following areas: Budgeting, Cost Accounting, Clinical Resource Management, Financial Business Planning, and Managed Care Contracting.
Full-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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In conjunction with the VP of Managed Care Contracting & Payor Relations/legal department, reviews and negotiates any new 340B contracts and renegotiation of existing transaction fees.
$65,000 a yearExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Preference for a candidate that has knowledge of managed care and governmental program reimbursement programs. College graduate, with persuasive written and verbal communication skills, some experience in business development, marketing, contracting, and admissions.
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Understanding of managed care, retail, and specialty pharmacy network concepts and PBM plan designs is highly desired. Minimum 1 - 3 years PBM or Managed Care experience is highly desired.
Full-timeRemoteExpandApply NowActive JobUpdated 3 months ago
contracting managed care jobs
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