• Medical Staff Specialist

    Trinity Health (Livonia, MI)
    …MSOW database and ensures mailing addresses, telephone numbers, participation in various managed care organizations, and other key demographics are up to ... Fields telephone calls and monitors shared email inbox regarding managed care products, application requests, credentialing/recredentialing procedures, etc.… more
    Trinity Health (12/02/25)
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  • Director Provider Network Operations

    AmeriHealth Caritas (Charleston, SC)
    …Degree or equivalent experience preferred with emphasis in health services administration, managed care , or equivalent experience required + Minimum **five (5) ... years** of management experience in a managed care setting, managing teams and projects **required** + Minimum **five (5) years** of experience in healthcare… more
    AmeriHealth Caritas (11/24/25)
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  • MCO Director Payment Integrity

    AmeriHealth Caritas (Newtown Square, PA)
    …and insights + At least ten (10) or more years of experience in managed care operations/administration + Working knowledge of CMS guidance and experience with ... history of success in triaging, resolving, and optimizing cross-functional processes within managed care organizations + Ability to work collaboratively with… more
    AmeriHealth Caritas (11/21/25)
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  • Director of Revenue Analysis

    Tenet Healthcare (Commerce Township, MI)
    …charges (eg, ABN not signed, denials, disputes, bad debt). 4. Reviews proposed managed care contracts and identify any issues or concerns with implementation ... loaded correctly into IMaCs and claims properly adjudicated during and after managed care negotiations. 6. Monitors/reviews billing, A/R and reconciliation for… more
    Tenet Healthcare (11/21/25)
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  • Senior Manager Coding and Billing

    HCA Healthcare (Nashville, TN)
    …support to various teams, including payer contracting and analytical teams, payer relations, managed care , legal support, and service line leaders. Your primary ... best practices when collaborating with customers and peers. + Assist the Payor Relations Managed Care teams and Managed Care Legal teams in proactively… more
    HCA Healthcare (10/12/25)
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  • Field Reimbursement Manager (Immunology…

    J&J Family of Companies (Fresno, CA)
    …to address critical access and affordability issues for patients. + Partner with managed care colleagues to understand current policies and potential future ... solutions across multiple payer types and plans (ie, Medicare, Medicaid Managed Care , Commercial). + Execute business in accordance with the highest ethical,… more
    J&J Family of Companies (12/18/25)
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  • Manager, VBC Analytics, Medicaid

    CVS Health (Hartford, CT)
    …handling financial data - claim, revenue, restatement, etc. + Prior experience in Medicaid managed care and/or value based care , or medical underwriting. ... Knowledge of managed care , provider contracts and provider reimbursement methodologies. + Understanding...provider contracts and provider reimbursement methodologies. + Understanding of managed care and how provider reimbursement policies… more
    CVS Health (12/17/25)
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  • Verification Specialist - PMPH

    Penn Medicine (Plainsboro, NJ)
    …significant knowledge of all types in-network and out-of-network health insurance, managed care companies, benefits and policies for commercial, Medicare ... and requirements + Ability to develop a good working relationship with managed care organizations, and provide excellent customer service + Ability to be… more
    Penn Medicine (12/03/25)
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  • Vice President Provider Network Management

    AmeriHealth Caritas (Southfield, MI)
    care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral ... physician practice chief executive officers, chief financial officers, directors of managed care , other high-level executives, and AmeriHealth Caritas's… more
    AmeriHealth Caritas (11/11/25)
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  • Immune Hematology Manager Upstate

    Sanofi Group (New York, NY)
    …working relationships with various members of the Sanofi Team including Marketing, Managed Care , Analytics, Accounting, Compliance, Legal and other team members. ... + Maintain extensive knowledge of the Managed Care , GPOs, Specialty Pharmacy, State Medicaid and Veterans Affairs selling and reimbursement environment for their… more
    Sanofi Group (10/18/25)
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