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About NYC Health + Hospitals Metro Plus Health provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, Metro Plus Gold, Essential Plan, etc.
$150,000 - $157,236 a yearFull-timeExpandApply NowActive JobUpdated 3 months ago - UpvoteDownvoteShare Job
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G PhD, DrPH, PharmD, MS) Minimum 10 years of relevant experience with a Master degree (or 7 years with a doctoral degree) working in HEOR and/or RWE outcomes research in the pharmaceutical, managed care or consulting industries.
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We are a highly motivated, past-paced team with extensive experience in negotiations, managed care, finance, and consulting, and are at the center of DaVita’s strategy to evolve from fee for service reimbursement to value based care.
$110,100 - $161,700 a yearFull-timeExpandApply NowActive JobUpdated 3 months ago - UpvoteDownvoteShare Job
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Our endocrinology team, led by medical director, Dr. Paul Thornton, is comprised of 13 board certified pediatric endocrinologists, 4 pediatric nurse practitioners, 9 certified diabetes care and education specialist, 2 psychologists, 4 nutritionists and a social worker.
Full-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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2+ years 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.
Starting at $161,914.25 - $315,732.79 a year depends on education, experienceFull-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Managed care, contracting, policies, and procedures. minimum three (3) years of healthcare experience in managed care. Role requires knowledge of health care, managed care.
$72,067.77 - $93,687.81 a yearExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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MHA provides expertise in Group Purchasing, Managed Care and Payer Contracting, Reimbursement Management, Specialty Pharmacy Solutions, Pharmaceutical Data Analytics, Consultant Pharmacy Software and Legislative Advocacy.
RemoteExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Under the direction of the Operations Director and Executive Director, this position is responsible for the negotiation, optimization and the operational management of the managed care contracts; Medi-Cal, Medicare, Commercial, PPO, FFS and etc.
Full-timeExpandApply NowActive JobUpdated 22 days ago - UpvoteDownvoteShare Job
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Preferable board certified or board eligible in primary care specialty (Family Practice, Internal Medicine, Emergency Medicine, Public Health or Occupational Medicine) with administrative experience in corrections and/or managed healthcare delivery.
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To be considered for this position at a minimum you need a Clinical/Science degree (MD, PharmD, PhD, DVM with 5 + years related work experience (clinical, managed care, or industry experience) in Ophthalmology is preferred.
ExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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Understand managed care/Prospective Payment System (PPS) billing and treatment guidelines. Performs all other duties as assigned by Rehabilitation Director. Enhancing clinical expertise, professional and management skills through interaction with managers, therapists and other professional staff, self-study, and other continuing education activities; maintaining valid state license (where appropriate); obtain membership and participate in professional organizations; maintain awareness of issues related to the profession of physical therapy and the health care environment.
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Performance Management & Regulatory Compliance: Develop and implement performance metrics, monitor key performance indicators, and provide feedback to clinicians to improve productivity, efficiency, and quality of care in conjunction with the Quality Director and development and implementation of Quality Improvement Plan. Participates in the review of managed care performance data and implementation of corrective action as needed.
Full-timeExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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Freedom from complex, restrictive managed care policies and reimbursement hassles. The Site Medical Director will collaborate with Health Services Administrator at the site to ensure efficient and clinically appropriate medical services are provided, and will participate in various committees to include Continuous Quality Improvement, Infection Prevention and Control and Pharmacy and Therapeutics as requested.
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We are currently seeking an experienced Physician to serve as the full-time Site Medical Director at Tipton Correctional Center located in Tipton, Missouri. The Site Medical Director also provides direct clinical services for patients and clinical supervision for medical staff of assigned site(s) under the supervision of the Statewide Medical Director.
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Must possess a thorough understanding of Medicare, Medicaid, Private Insurance, Managed Care costing and analysis, personnel management, accounts receivable/collections, resident funds, accounts payable, general ledger, and management of information systems.
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