• Case Manager - PRN

    Houston Methodist (The Woodlands, TX)
    …services by communicating medical information required by all external review entities, managed care contracts, insurers, fiscal intermediaries, and state and ... tasks and role components + Knowledge of Medicare, Medicaid and Managed Care requirements + Comprehensive knowledge of community resources, health care more
    Houston Methodist (11/07/25)
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  • Director of Authorization-Patient Financial…

    Mount Sinai Health System (New York, NY)
    …effectively. . Organize routine meetings with health system business leaders and managed care teams to review authorization performance, payer issues, and ... relationships with key stakeholders across departments (eg, DTP, Human Performance, Managed Care , Finance, and clinical departments). . Collaborate with… more
    Mount Sinai Health System (11/05/25)
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  • Practice Manager

    Penn Medicine (Philadelphia, PA)
    …practice revenue cycle management/oversight. Ensure practice alignment with all standards. Managed Care /Payer Management - Support implementation of managed ... our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future...* 10+ = # of staff directly and indirectly managed * 15,000+ = # of budgeted annual visits… more
    Penn Medicine (11/04/25)
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  • Utilization Review Specialist Nurse (RN) | Case…

    Houston Methodist (Houston, TX)
    …by communicating medical information required by all external review entities, managed care contracts, insurers, fiscal intermediaries, state, and federal ... national coverage determinations + Comprehensive knowledge of Medicare, Medicaid, and Managed Care requirements + Comprehensive knowledge of community resources,… more
    Houston Methodist (11/02/25)
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  • Contracting Program Manager

    Beth Israel Lahey Health (Wakefield, MA)
    …the Executive Director, Contracting to manage key divisional initiatives that support Managed Care Contracting. The Contracting Program Manager will be ... obligations within contracts to serve as the operational backbone for Managed Care Contracting . This position is responsible for aggregating relevant contract… more
    Beth Israel Lahey Health (10/30/25)
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  • Senior Contract Manager Analyst - Mount Sinai…

    Mount Sinai Health System (New York, NY)
    …+ Opportunity to work at the forefront of innovation in healthcare The Managed Care Contracting Team within MSHP is responsible for the negotiation, ... related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's subject matter experts on:… more
    Mount Sinai Health System (10/29/25)
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  • Senior Denials Mgmt Specialist

    Houston Methodist (Sugar Land, TX)
    …determinations and, denial reason and trending as appropriate, Monitors CMS, managed care and payor communications for updates/alerts/releases and functions ... knowledge of Federal, State, and local billing regulations and partners with managed care contracting as needed. + Maintains knowledge of contracts, payor plans… more
    Houston Methodist (10/29/25)
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  • Senior Contracting Analyst Lead - Mount Sinai…

    Mount Sinai Health System (New York, NY)
    …+ Opportunity to work at the forefront of innovation in healthcare The Managed Care Contracting Team within MSHP is responsible for the negotiation, ... related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's subject matter experts on:… more
    Mount Sinai Health System (10/21/25)
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  • Senior Contracting Compliance Analyst…

    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 ... related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's subject matter experts on:… more
    Mount Sinai Health System (10/08/25)
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  • Representative, Provider Relations HP - Remote

    Molina Healthcare (Dallas, TX)
    …* 2 - 3 years customer service, provider service, or claims experience in a managed care setting. * Working familiarity with various managed healthcare ... discuss and resolve issues related to utilization management, pharmacy, quality of care , and correct coding. * Independently delivers training and presentations to… more
    Molina Healthcare (11/28/25)
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