• 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 (01/28/25)
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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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  • Contract Implementation Analyst

    Centene Corporation (Baton Rouge, LA)
    contract implementation, contract analysis or claims analysis experience in managed care , health care or TPA setting. Government programs and ... Requests (CRs) (ie RHCs/FQHCs/fee schedule updates). + Troubleshoot and problem solve contract implementation issues related to basic system configuration +… more
    Centene Corporation (04/11/25)
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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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  • Claims Implementation Analyst

    Healthfirst (NY)
    …+ Complete other projects and duties as assigned. **Minimum Qualifications:** + Managed care , commercial health plan (or other healthcare related) experience ... rules within the claims processing system. + Identify claims configuration and contract implementation defects and improve...+ Knowledge of healthcare claims processing practices in a managed care setting a plus. + Bachelor's… more
    Healthfirst (02/22/25)
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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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  • Director Provider Network Management - HAP

    Henry Ford Health System (Troy, MI)
    …knowledge of provider contracts and market strategies with subject matter expertise in managed care , provider reimbursement models, national health care ... negotiated contracts and coordinates activities with Provider Reimbursement and Business Configuration Team to support contract implementation. Executes data… more
    Henry Ford Health System (04/15/25)
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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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