- Highmark Health (Pittsburgh, PA)
- …understanding of clinical reimbursement , federal and state regulations, and managed care issues. Identifies opportunities to optimize clinical ... trends, policies, and issues affecting physician practices. + Familiarity with risk, managed care , capitation, ACO development, and population health management.… more
- Zions Bancorporation (Midvale, UT)
- …business areas. The successful candidate will have experience with handling pharmacy contracts, managed care contracts, or other contract background; be able ... UT. This position will assist with management of the contract lifecycle for our clients, including template setup, ...+ Health Savings (HSA), Flexible Spending (FSA) and dependent care accounts + Paid Training, 15 days of Paid… more
- PVH Corp. (Bridgewater, NJ)
- ….com Services:** Access to services for childcare, elder care , adoption preparation, pet care , plus reimbursement for backup care when your regular plans ... service quality, customer satisfaction and operational efficiency next to owning contract management, delivering top-tier service to our associates. The diversity… more
- AmeriHealth Caritas (Raleigh, NC)
- …position working with providers. + 3 to 5 years experience in the managed care /health insurance industry. + Medicaid experience preferred. + Demonstrated ... assuring financial integrity of the Plan is maintained and contract management requirements are adhered to, including language, terms...to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and… more
- Grifols Shared Services North America, Inc (New York, NY)
- …strategy, aligns tactics to the needs of the customer + Remain cognizant of managed care coverage throughout the business territory including major accounts and ... + Educate and promote IG product portfolio to customers including Primary Care Physicians, Allergists, Neurologists, Pharmacists, and Nurses. + Key Opinion Leader… more
- Walmart (Bentonville, AR)
- …of direct experience in contract negotiation within the PBM, pharmaceutical, or managed care environment. + Deep understanding of the pharmacy supply chain, ... **What you'll do ** + Lead all phases of contract negotiation with PBMs (Pharmacy Benefit Managers) and Health...reimbursement models, and standard industry legal frameworks. + Proven… more
- AmeriHealth Caritas (Charleston, SC)
- …a healthcare setting. + 3 years of supervisory/management/leadership experience, preferably in a managed care organization setting. + Must be able to communicate ... care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral… more
- The County of Los Angeles (Los Angeles, CA)
- …operational areas, clinic, or programs overseen; ensures that budget and contract allocations reflect program priorities; and takes corrective action where ... compliance with Federal and State Medicare and Medicaid regulations for reimbursement claiming and maximum recovery costs for directly operated billable services.… more
- Amgen (New York, NY)
- …metrics, CHF/interventional performance priorities) + District Management Experience preferred + Reimbursement / managed care experience highly desirable ... Develops and executes innovative strategies to reach difficult to access health care providers and accounts in a compliant manner + Maintains comprehensive account… more
- New York State Civil Service (Albany, NY)
- …models and reimbursement rate methodologies for CDPAS providers and managed care plans; Prepare briefing materials-PowerPoints, policy memos, data ... administration of progressively responsible experience in Medicaid policy, program implementation, or managed care operations; OR a bachelor's degree and five… more