Director Of Managed Care Jobs

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739 Director Of Managed Care jobs found on Monster.

Jobs 1 to 20 of 739
Physicians Plus Insurance Corporation is currently recruiting for a Director of Managed Care to join our leadership team. The Director of Managed Care position is accountable for the development and achievement of NCQA-compliant medical management strategies through synchronization with the provider network. These strategies will ensure members access to medically necessary, cost effective medical...
Children’s Hospital Colorado, ranked a top 10 Children’s Hospital, is seeking a Director of Managed Care position. A career at Children's Colorado will challenge you, inspire you, and motivate you to make a difference in the life of a child. The Director will manage the financial and legal aspects of relationships with a wide variety of payors/providers, including commercial health plans, medical...
Job Title: Regional Managed Care Director Location: Base city in TX (responsible for TX, AR, LA, MS, OK, and KS) Position: Contracting Managed Care Organizations and State Medicaid programs About the Company We are working with a highly specialized Pharmaceutical Company that is focused on the one of the highest cost health conditions to assist in reducing healthcare cost and insure a good and hea...
Treating you better…for life. Saint Peter’s University Hospital was founded in 1907 and is part of the Saint Peter’s Healthcare System formed in 2007 that also includes the Saint Peter’s Foundation and Saint Peter’s Health and Management Services Corporation, which oversees various initiatives (the Margaret McLaughlin McCarrick Care Center, CARES Surgicenter, and Adult Day Center in Monroe). Saint...
Must have a Managed Healthcare background! The Regional Director, Member Services is responsible for the continued development and enhancement of a Member Services department in a Managed Healthcare Call Center setting, including the implementation of standard processes, policies and procedures. You will work closely with the health plans leadership to ensure compliance with all company regulatory...
Description The Director, Regional Operations, Florida Region is responsible for negotiating local Managed Care agreements with applicable health plans such as Florida Blue, AvMed, Simply Health Plans and other State-specific health plans. Developing and maintaining strong relationships with the personnel at these local health plans is very important to Tenets success. The person in this position...
Summary of Position: Responsible for the development, implementation and coordination of managed care programs and activities for Pioneer Health Services hospitals, nursing homes, and free standing clinics. Duties Include but are not limited to: -Manage care payer negotiations -Development and implementation of strategies, goals and objectives for successful completion of negotiations, identificat...
Responsible for contracting and negotiations for SJRMC with insurance companies, networks, and payors. Oversees dissemination of information and the implementation of contracts once contracts have been finalized. Acts as a managed care consultant for all SJRMC affiliates. JOB DUTIES 1. Actively demonstrates the organization’s mission and core values, and conducts oneself at all times in a manner c...
DIRECTOR HEALTH INFORMATION MANAGEMENT SEARCH We have been retained by a large, prominent, not for profit, metropolitan NYC multi-site Managed Long Term Care Program (MLTCP) - part of a larger health care organization offering a full continuum of care to the elderly - to locate a hands-on Director of Health Information Management (HIM). These MLTCP Plans are the wave of the future in managed healt...
Regional Managed Markets Director (RMD) Alkermes is a leader in innovative medicines that address the unmet needs and challenges of people living with debilitating diseases. As a fully integrated global biopharmaceutical company, Alkermes applies our scientific expertise, proprietary technologies, and global resources to develop products that are designed to make a meaningful difference in the way...
The Regional Director, Member Services is responsible for the continued development and enhancement of a Member Services department in a Managed Healthcare Call Center setting, including the implementation of standard processes, policies and procedures. You will work closely with the health plans leadership to ensure compliance with all company regulatory and industry standards. The Regional Direc...
RESPONSIBILITIES: Our client is seeking a Pharmacy Tech w/ Managed Care in Los Angeles, CA. Candidate will be responsible for the pharmacy Prior Authorization process to ensure that company provides non- formulary and restricted drugs in compliance with all regulatory and state contract requirements. The Technician will perform all aspects of the prior authorization process including processing pr...
Description Extendicare Midwest Operations is currently interviewing for a Managed Care Intake Specialist. Qualified candidates will be a Registered Nurse. Managed Care, case management, and long-term care experience is preferred. POSITION SUMMARY: Responsible for streamlining the managed care intake process for obtaining insurance verification, authorizations for initial rates and exclusions for...
Xcenda is a premier, full-service consultancy and leading managed markets agency. For more than 2 decades, global biopharmaceutical companies as well as emerging pre-commercialization phase firms have turned to Xcenda for strategic insights, health economics and outcomes research expertise, and reimbursement support. We help manufacturers successfully commercialize innovative medical treatments an...
Job Location: Boston, MA Job Description Job Summary: The Managed Care Analyst will be responsible for developing and producing new health care efficiency and quality data for the purpose of measuring clinical performance at both the health system and individual provider level. In addition, they will spend time interacting with programmers to implement reports on a production basis and communicate...
RESPONSIBILITIES: Our client is seeking a Project/ Operations Mgr. Managed Care -Rev Cycle for their Los Angeles, CA location. This is a great opportunity but a temporary position with this company. Job Duties: Supports the Director of Medical Payment systems & services (MPSS) in overseeing day-to-day operations of the MPSS department Manages a team of Senior Financial Analysts, Program Manager, P...
Health Quest is the Hudson Valley’s largest integrated family of hospitals and health care providers, delivering the highest quality care across a variety of service lines, including Cancer Care, Cardiac Care, Orthopedics, Neurosciences, Women’s and Children’s Services and Surgical Services. Our family includes three awarding-winning hospitals—Northern Dutchess Hospital in Rhinebeck, Putnam Hospit...
Description Responsible for Managed Care reimbursement compliance. Assists Director in special projects. Please note position required that if an offer is extended and accepted, a background check including a credit check will be performed. Qualifications Education High School Diploma required and some college preferred. Skills and Abilities Effective oral and written communication skills; Strong...
RN Team Nurse for Managed Long Term Care Program Full time - Menorah Licensed Home Care Responsibilities: Menorah Licensed Home Care Agency is seeking a registered Nurse to work full time at Total Aging In Place Program in Amherst, NY. The nurse is part of an Interdisciplinary Team Responsible for assessing and coordinating the clinical care needs of members, implementation and oversight of member...
Responsible for the administrative functions of the Managed Care Department. Works under the direction of the Managed Care Director to ensure all compliance and quality requirements are met. Works closely with the State Department of Social Service and State Department of health officials on issues pertaining to managed care programs. • Ensures all managed care contracts with designated HMO’s are...

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