• Manager Provider Network Management

    AmeriHealth Caritas (Manchester, NH)
    …Physician Practice Chief Executive Officers, Chief Financial Officers, Directors of Managed Care , and other high-level executives. **Work Location:** Manchester, ... New Hampshire (Hybrid schedule) **Roles and Responsibilities:** + Lead strategic planning, development, and management of the hospital...+ A minimum of 3 years of experience in managed care provider contracting and reimbursement is… more
    AmeriHealth Caritas (08/14/25)
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  • Medical Management Nurse (US)

    Elevance Health (Mason, OH)
    …experience and requires a minimum of 2 years clinical, utilization review, or managed care experience; or any combination of education and experience, which ... and Experiences:** + Certification in the American Association of Managed Care Nurses is preferred. + Knowledge...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
    Elevance Health (10/04/25)
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  • Provider Relations Rep

    Dignity Health (Bakersfield, CA)
    …more years of account management experience working with a medical group or IPA in a managed care environment. + 5 or more years' experience working in a similar ... authorization, claims administration and provider network administration. Familiarity with managed care and self-insurance products and benefits. **Preferred… more
    Dignity Health (09/25/25)
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  • Vice President - Pharmacy

    GEHA (Lee's Summit, MO)
    …and lines of business. The ideal candidate is a PharmD with deep PBM and managed care experience, strong financial and regulatory acumen, and a proven record of ... formulary design, and utilization management + Strategic and operational leadership in a managed care or integrated health plan environment + Strong financial… more
    GEHA (09/12/25)
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  • Medical Director - Mid West Region

    Humana (San Juan, PR)
    …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... experience, and judgement to make determinations whether requested services, level of care , and/or site of service should be authorized. All work occurs within… more
    Humana (09/16/25)
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  • Senior Program Associate

    New York University (New York, NY)
    …and motivated individual to serve as a senior program associate for our Managed Care Technical Assistance Center (MCTAC) and Healthcare Innovation team. This ... and training resources. The Program Associate may also support the projects of the Managed Care Technical Assistance Center (MCTAC), an initiative funded by the… more
    New York University (08/07/25)
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  • Senior Program Manager - DC Market Operations…

    CareFirst (Washington, DC)
    …capacity. **Preferred Qualifications:** + Master's Degree + Experience in Medicaid or Medicare managed care , managed care insurance, finance, government, ... Chief External Operations Officer. **ESSENTIAL FUNCTIONS:** + Oversee and lead RFP readiness efforts for market expansion + ... care setting or related field. + DC Managed Care experience. **Knowledge, Skills and Abilities… more
    CareFirst (09/19/25)
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  • Manager of Business & Regulatory Affairs - Heart…

    Beth Israel Lahey Health (Boston, MA)
    …expenses on Medicare Cost Report including mgmt of time studies. Liaisons with managed care to optimize contracts. Represent heart transplant with internal and ... internal teams for creation of charges, billing workflows and managed care contracting. (essential) 4. Maintains knowledge...across multiple functional areas. 7. Team Work: Ability to lead collaborative teams for larger projects or groups both… more
    Beth Israel Lahey Health (08/08/25)
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  • Medical Director - Northeast Region

    Humana (Raleigh, NC)
    …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... + MD or DO degree + 5+ years of direct clinical patient care experience post residency or fellowship, which preferably includes some experience in an… more
    Humana (07/25/25)
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  • Field Reimbursement Manager (Immunology…

    J&J Family of Companies (Sioux Falls, SD)
    …to address critical access and affordability issues for patients. + Partner with managed care colleagues to understand current policies and potential future ... and affordability solutions across multiple payer types and plans (ie, Medicare, Medicaid Managed Care , Commercial). + Execute business in accordance with the… more
    J&J Family of Companies (10/03/25)
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