• Managed Care Contract

    BayCare Health System (Clearwater, FL)
    …on a foundation of trust, dignity, respect, responsibility and clinical excellence. **The Managed Care Contract Configuration Specialist:** + Maintains ... Time, Exempt: Yes **Shift Hours:** 8am-5pm Equal Opportunity Employer Veterans/Disabled **Position** Managed Care Contract Configuration Specialist… more
    BayCare Health System (03/15/25)
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  • Executive Director, Managed Care

    University of Miami (Medley, FL)
    …in managed care . + Leads and manages care staff, including network contracting, contract implementation/operations, non-participation agreements, ... sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The Department of Business Development and Managed Care is currently seeking an Executive… more
    University of Miami (04/28/25)
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  • Configuration Application Manager, Tapestry

    UCLA Health (Los Angeles, CA)
    Description Under the direction of the Managed Care Operations Assistant Director, the Application Manager (AM) will be the primary expert in support of the ... + Minimum of seven years of Health Plan claims adjudication and provider contract configuration /analysis required + Minimum of three years of experience specific… more
    UCLA Health (04/03/25)
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  • Epic Reimbursement Contract Specialist-…

    Bozeman Health (Bozeman, MT)
    …appeal confirmed underpayment instances, and continuously build and maintain system contract configuration to ensure accuracy against payer reimbursement terms. ... in a multi-entity health care system, large hospital, physical office, or managed care organization. Essential Job Functions: In addition to the essential… more
    Bozeman Health (01/30/25)
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  • MES Global Quality Champion - Fixed Term…

    ConvaTec (Greensboro, NC)
    …on solutions for the management of chronic conditions, with leading positions in advanced wound care , ostomy care , continence care , and infusion care . ... of at-risk skin, to improved patient outcomes and reduced care costs. Convatec's revenues in 2023 were over $2...do the same. This role is a fixed term contract position with the expectations of lasting approximately 2… more
    ConvaTec (04/17/25)
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  • Medicaid Provider Network Resolution Claims…

    AmeriHealth Caritas (Washington, DC)
    care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral ... Maine Avenue, SW, Suite 1000, 10th Floor, Washington, DC 20024 **Responsibilities:** The Managed Care Provider Network Resolution Analyst is responsible for … more
    AmeriHealth Caritas (04/03/25)
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  • Provider Contracts Manager

    Molina Healthcare (Houston, TX)
    …in health care field including, but not limited to, provider's office, managed care , or other health care field. **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS ... specialty or multispecialty provider groups. * 3+ years experience in provider contract negotiations in a managed healthcare setting **PREFERRED EXPERIENCE** :… more
    Molina Healthcare (04/25/25)
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  • ABMS Senior Systems Engineer - Secret Clearance…

    RTX Corporation (Aurora, CO)
    …C27, Richardson, TX, 75082 USA **Position Role Type:** Onsite **Raytheon Company, Managed by Collins Aerospace** THIS POSITION IS CONTINGENT UPON CONTRACT ... with network-specific data models (eg, YANG, OpenAPI) to support policy-driven configuration of routers, switches, and firewalls + Configuration Management… more
    RTX Corporation (03/25/25)
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  • Director Plan Operations & Administration

    AmeriHealth Caritas (Baton Rouge, LA)
    care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral ... to ten (5 to 10) years progressive manager/leader experience in a Managed Care Organization preferred.; + Solid understanding of Medicare/Medicaid operations… more
    AmeriHealth Caritas (03/12/25)
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  • Provider Network Operations Analyst

    AmeriHealth Caritas (Charleston, SC)
    care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral ... monitor the accuracy of benefit interpretation, claim payment, provider contract configuration , eligibility processing, and revenue-generating interfaces across… more
    AmeriHealth Caritas (04/24/25)
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