- CGI Technologies and Solutions, Inc. (Chantilly, VA)
- …daily support to triage, prepare, facilitate, and administrator acquisition actions managed through the Sponsor's Business Enterprise. This position is located in ... Sponsor acquisition professionals throughout an acquisition lifecycle, to include Contracting Officer's Technical Representative (COTR) and Contracting Officer… more
- CVS Health (Springfield, IL)
- …do it all with heart, each and every day. Aetna Better Health is Aetna's Medicaid managed care plan. Backed by over 30 years of experience managing the care ... (ABHIL)** is seeking an experienced leader with deep operational expertise in Medicaid Managed Care to serve as **Chief Operating Officer (COO)** for its… more
- 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 ... regulations and requirements + Ability to develop a good working relationship with managed care organizations, and provide excellent customer service + Ability… more
- Humana (Springfield, IL)
- …trainings. + Attend Network Meetings/Conferences. Ensure compliance with all Virginia managed care contractual requirements for provider relations, such as ... able to travel throughout Illinois as needed for role. + 2+ years of health care or managed care experience working with providers (eg, provider relations,… more
- Point32Health (Canton, MA)
- …industry **Experience** + Required (minimum): A minimum of 5-7 years' experience Managed Care , preferably at a Health Plan, in a ... Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to...changes to vendor programs on an annual basis. **Vendor Contracting ** + Work with finance and internal business owners… more
- Amgen (Atlanta, GA)
- …applicable competitors, specialty experience + District Management / Reimbursement / managed care experience + Demonstrates solid understanding of the ... innovative market strategies to reach difficult to access health care providers and accounts in a compliant manner. +...accounts in a compliant manner. + Amgen Bone Health contracting point. + Leads contract delivery, business reviews and… more
- CareFirst (Baltimore, MD)
- …management experience on the payer side using MCG criteria. Working knowledge of managed care and health delivery systems. + Thorough knowledge of CareFirst ... prospective, concurrent and retrospective reviews for authorization, appropriateness of care determination and benefit coverage. Leveraging clinical expertise and… more
- Veterans Affairs, Veterans Health Administration (Manchester, NH)
- …VAMC, HBPC and CBOC outreach clinics. Ancillary testing or Point of Care testing scope is: Ancillary Glucose, Troponin, BNP, Dipstick Urinalysis, urine pregnancy, ... Incumbent as the authority and expert for point of care testing will be responsible for all ATC, Core...a split position: ATC/Core Laboratory Supervisor which will be managed through the office of the Laboratory Manager. Work… more
- HCA Healthcare (Denver, CO)
- …and analyze a wide range of data. + Must possess knowledge about managed care andthird-partycontractual arrangements and have the ability to analyze such ... a(an) Admin Director Operations and Finance with HealthONE Colorado Care Partners, you can be a manager in an...HOCCP. Over sees all data and physician and payer contracting . Payer relations and contract negotiation management. Client decision… more
- Molina Healthcare (Tampa, FL)
- …guidelines. + Experience in Utilization/Quality Program management + HMO/ Managed care experience **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** ... and action plan, which includes strategies that ensure a high quality of patient care , ensuring that patients receive the most appropriate care at the most… more