Managed Care Network Administrator Job at The Muse (Burlington)

Provider Management Consultant

This role is responsible for supporting development and growth of positive, long...

Location

United States , Chicago

Salary:

60300.00 - 133400.00 USD / Year

Health Care Service Corporation

Expiration Date

Until further notice

Requirements

Bachelor's Degree with 5-7 years experience in a Healthcare or Managed Care environment
3 or more years of hands-on experience in Provider Contracting, Network Management, or Provider Relations
Proven planning, preparation and presenting skills, with established knowledge of reimbursement and bonus methodologies
Demonstrated ability to manage multiple projects and meet deadlines
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Proficiency in analyzing and interpreting financial trends for health care costs, administrative expenses and quality/bonus performance
Detail oriented professional with excellent written and verbal communication skills
CMS regulatory requirements, including Medicare Marketing Guidelines
Experience with Medicare products (including Medicare Advantage, Medicare Prescription Drug Plan (PDP) and Medicare Supplement products)

Job Responsibility

Support development and growth of positive, long-term relationships with physicians, providers, multi specialty clinics, and healthcare systems to support and improve financial and quality performance within the contracted working relationship with the health plan
Identify the business plan and have growth objectives
Navigate the C Suite and execution of strategies in conjunction with the HCSC Contracting teams

Fulltime

Vice President of Payer Contracting

The Vice President of Payer Contracting provides strategic and operational leade...

Location

United States , South Burlington

Salary:

320838.00 - 481258.00 USD / Year

The University of Vermont Health Network

Expiration Date

Until further notice

Requirements

Bachelor's degree in business, Healthcare Administration, Finance, or related field required
Master’s degree (MBA, MHA, MPH, or equivalent) is strongly preferred
Juris Doctor (JD) is required
10+ years of progressive experience in managed care contracting within a health system, integrated delivery network (IDN), or payer organization
Proven success in developing and negotiating value-based and risk-sharing contracts
Strong understanding of payer reimbursement methodologies, population health models, and alternative payment programs (e.g., ACOs, bundled payments, shared savings)
Experience conducting significant managed care payer negotiations
Analytic-minded leader with depth of experience in contract modeling and assessing financial implications of new contracting structures
Possess understanding of emerging trends in value-based contracting and payment innovation, such as physician compensation redesign, patient centered medical homes, bundled payments, and commercial, federal and state ACO programs

Job Responsibility

Provides strategic and operational leadership for all payer contracting initiatives across the health system
Developing, negotiating, and managing commercial and government payer agreements that align with the organization’s high value care strategy, operations, and advances the organization’s commitment to value-based care, quality outcomes, and financial sustainability
Shaping payer partnerships that reward high-quality, efficient care delivery and support the system’s transformation toward risk-based and population health models
Leading contracting for hospitals, physician enterprise and post-acute facilities within the health system

What we offer

Relocation support is available to a final candidate who does not already live in the region served by UVM Health

Fulltime

Private Client Director

An award winning, top 200 law firm is currently searching for a Private Client D...

Location

United Kingdom , London

Salary:

Not provided

Douglas Scott

Expiration Date

Until further notice

Requirements

Proven experience in team management and working towards key performance indicators (such as chargeables and billing)
In-depth knowledge and experience in Wills and Probate work, with the capability to handle privately funded cases
5+ years PQE (Post-Qualification Experience)
Must hold a valid, clean Practising Certificate at the time of application
Professional and proactive, with strong client care skills, the ability to manage client matters sensitively, and resolve complex issues
Excellent networking and communication skills, with the ability to effectively market the firm and attract new business
Strong analytical and organisational abilities
Capable of working independently and exercising sound judgement
Proficient in IT, with familiarity in Microsoft Office applications and document management systems

Job Responsibility

Oversee all aspects of Wills and Probate work
Assist with casework across a variety of Wills, Probate, and Lasting Powers of Attorney matters, including estate administration, probate applications, trust establishment, inheritance tax advice, Court of Protection matters, will contests, and tax liability settlements
Report directly to the Board and work collaboratively to achieve performance goals
Supervise a team of solicitors, trainee solicitors, and paralegals handling private client matters
Manage a caseload with a range of complexities, ensuring quality and timeliness
Meet with clients, gather instructions, and prepare case files
Handle correspondence and maintain accurate time-costing records
Conduct probationary reviews for new staff and perform monthly file reviews, ensuring prompt follow-up on required actions
Ensure compliance with file management and organisation standards

What we offer

Hybrid working/ flexible working arrangements
Bonus scheme
Salary reviews

Fulltime

Senior medical network officer

We are seeking a diligent and communicative (Senior) Medical Network Officer to ...

Location

Hong Kong , Hong Kong

Salary:

25000.00 - 40000.00 HKD / Year

Randstad

Expiration Date

May 17, 2026

Requirements

Bachelor’s degree in Healthcare Administration, Nursing, Business, or a related field
At least 2–5 years of professional experience in medical network management, insurance operations, or healthcare administration
Strong understanding of the Hong Kong private healthcare landscape and managed care systems
Excellent negotiation skills with a proven ability to build long-term professional relationships with medical practitioners
High level of proficiency in both written and spoken English and Cantonese
Meticulous attention to detail with the ability to manage complex contracts and large datasets
Proficient in MS Office suite, particularly Excel for data tracking and reporting

Job Responsibility

Spearhead the credentialing and onboarding of medical providers to expand and strengthen the healthcare practitioner network
Serve as the primary liaison for existing medical partners, managing contract renewals and negotiating fee schedules to ensure mutual alignment
Conduct regular audits and quality assessments of network providers to maintain strict adherence to service level agreements and clinical standards
Collaborate with the claims and operations departments to resolve billing disputes or complex medical-administrative inquiries from the network
Analyze network utilization data and geographical coverage to identify gaps and implement strategic expansion plans
Organize and lead briefing sessions for medical providers regarding new insurance schemes, digital platform updates, and administrative protocols
Maintain an accurate and up-to-date database of provider information, ensuring all regulatory and compliance documentation is filed correctly
Contribute to the enhancement of digital provider portals to streamline communication and administrative workflows

Senior Manager Network Operations

The Manager of Network Operations leads a 24x7 network operations function respo...

Location

United States

Salary:

142121.00 - 227394.00 USD / Year

One Call

Expiration Date

Until further notice

Requirements

Bachelor's degree in Information Technology, Computer Science, Engineering, or related field, or equivalent practical experience
Relevant technical certifications preferred (for example Cisco, Aruba, F5, ZScaler)
5-7 years of information technology experience including NOC environment or comparable 24x7 operations
2+ years leading a technical operations or network team (direct people management or equivalent team leadership)
3 years project management preferred
Strong understanding of network operations and support concepts, including routing, switching, wireless, VPN, load balancing, and network security fundamentals
Demonstrated experience with remote support models, concepts, and monitoring tools
Working knowledge of Cisco, Aruba, wireless technologies, F5, ZScaler, Cisco VPN, and cloud networking considerations in Azure
Experience coordinating major incidents, driving clear escalation, and communicating status to technical and non-technical stakeholders
Ability to define and track operational KPIs (for example availability, incident response time, recurring incident reduction) and drive continual improvement

Job Responsibility

Leads day-to-day network operations for routing, switching, wireless, VPN, and load balancing services to ensure availability, performance, and stability
Manages a 24x7 operational coverage model, including on-call escalation, staffing coordination, and incident communications for high-impact events
Owns network incident and problem management practices, including triage, escalation, root cause analysis, and follow-through to reduce repeat issues
Manages the planning, installation, testing, modification, and evaluation of LAN and WAN services, coordinating changes to minimize risk and user impact
Oversees day-to-day administration and lifecycle management of core network platforms, including Cisco routing and switching, Aruba and wireless infrastructure, F5, ZScaler, Cisco VPN, and related Azure/AWS networking components
Defines system, quality, and analysis requirements, translating operational needs into functional specifications and effective processes
Develops and maintains processes and procedures for support and service delivery, including runbooks, escalation paths, and operational readiness checklists
Maintains and reports on SLA monitoring and compliance, including trends, recurring drivers, and improvement actions
Provides management reports, including comprehensive operational statistics, forecasts, and status reports
Analyzes statistical and operational data to maintain infrastructure health, identify systemic issues, and prioritize remediation work

Fulltime

Behavioral Health Medical Director

The Behavioral Health Medical Administrator (Medical Director) directs, leads, a...

Location

United States , Phoenix

Salary:

Not provided

Blue Cross Blue Shield of Arizona

Expiration Date

Until further notice

Requirements

3 years of experience in a clinical setting
1 year of experience in physician leadership role, including quality review, utilization review, population health and other managed care functions
Medical Degree
Active, current, and unrestricted license to practice medicine in the State of Arizona (a state in the United States)
Board Certification in general psychiatry, or adult and child/adolescent psychiatry, through the American Board of Psychiatry and Neurology
Requires knowledge and skills in state (Arizona) and federal behavioral health regulations, requirements for publicly funded services, delivery, operations, and licensure.
Knowledge of managed care concepts and practices
and emerging and best practices for adult & children’s integrated care programs.
Ability to use electronic word processing, email, and electronic database resources.
Excellent customer service and oral/written communication skills

Job Responsibility

Directs, leads, and provides professional oversight for medical management and population health activities related to behavioral health utilization management, case and care management, disease management, performance improvement, and quality management activities.
Supports collaborative relationships with physicians and hospitals to achieve mutually acceptable business goals in compliance with AHCCCS and CMS regulations.
Provides physician leadership and medical oversight in the design, implementation and review of clinical services, best practices, care management, medical management and quality management.
Serves as liaison between the Medicaid Business Segment and medical and behavioral health practitioners at stakeholder and provider agencies.
Participates in aggregate and member-level clinical analyses for quality management, quality of care concerns, peer review, medical management, and utilization review processes.
Reviews and authorizes requests by providers and treatment coordinators for services or programs requiring prior authorization.
Participates in the design and implementation of best practices, clinical standards, protocols, and treatment guidelines.
Participates in credentialing, re-credentialing and competency processes for providers.
Assists care managers with care management of high risk/high-cost members.
Participates as a member or chair of internal and external committees.

Parttime

Executive Director

The Executive Director is responsible for leading the community’s day-to-day ope...

Location

United States , Ardsley

Salary:

134000.00 - 160800.00 USD / Year

Atria Senior Living

Expiration Date

Until further notice

Requirements

A Bachelor’s degree in Business Administration, Healthcare Administration, or related subject is required
Three (3) to five (5) years of experience in operations management with demonstrated success in meeting financial and sales goals preferred
The ability to become licensed as an administrator for assisted living within a prescribed timeframe in states requiring such a license
Must possess a valid driver’s license
Position requires driving responsibilities (may use Company provided vehicle and/or personal vehicle)
Must satisfactorily meet and be in compliance with Company motor vehicle policy standards and Travel Policy

Job Responsibility

Lead the development and implementation of all sales and operations strategies and tactics for the community consistent with Company objectives
Regularly communicate performance with the Regional Vice President
Actively partner with Community Sales Director to assess competitive threats, sales plan, and engage in business-to-business sales calls
Understand the community’s care regulations and support the resident care program by regularly meeting with the Resident Services Director to discuss and address department concerns
Develop and implement successful strategies regarding labor, occupancy growth, revenue growth, expense control, and quality of services, and review and redirect activity, if necessary
Ensure adherence to the Resident’s Bill of Rights
Responsible for interviewing, hiring, training, developing, and evaluating assigned staff. Team sizes can vary
average range is 65-80
Constantly assess resident needs in staffing levels
Operate the community in accordance with Company policies and federal, state and local regulations

What we offer

Competitive Pay
Paid Holidays & PTO
Comprehensive Health Plans
Career Advancement Opportunities
Tuition Reimbursement
Employee Loyalty Rewards Program
Retirement Savings Plan with Employer Match
Rewards & Recognition
Health & Safety

Fulltime

Implementation Engineer- Medical Imaging

Are you interested in joining a growing leader in the exciting field of Healthca...

Location

United States

Salary:

Not provided

PaxeraHealth

Expiration Date

Until further notice

Requirements

Bachelor’s degree or college diploma, preferable in Computer Science, or equivalent experience
Healthcare Integration knowledge is a must (HL7, DICOM, IHE)
5+ years of experience in customer support
Excellent written and verbal communication skills
Willingness and ability to learn new technologies
Strong aptitude for solving problems independently and as a team
Shell scripts under bash or Ruby/Perl scripts
HTML, XML, PHP, and SQL
Experience with administration of standard service such as: IIS,Directory Server, NTP, NFS or OpenSSL
Good Knowledge of MS SQL DB management, Query and Administration.

Job Responsibility

Works within the Technical Support Services team to deploy and support products effectively, in a timely and collaborative manner.
Uses their broad support and Healthcare IT expertise and experience to lead the team to deliver outstanding customer service as perceived by our customers.
Works closely with their team and with Services Leaders, Projct Managers, Product Managers, Product Development and Sales teams to deliver outstanding service to our customers to improve patient care.
Work closely with the Solution Architects and Product Management to conduct technology, architecture, stakeholder assessments using common methodologies and processes.
Uses rigor and attention to detail to meet our quality objectives.

What we offer

Company Health, Dental and Vision Insurance
Life Insurance
PTO, including Holidays, Vacations, Sick and Personal days
401K with discretionary company match
Work with an outstanding and dedicated team of Sales, IT, Marketing, and Administrative professionals who are committed to our company’s growth
Work for a company whose values include: Integrity, Hard Work, Exceptional Service and Innovation
A friendly work environment with a family-owned feel!

Fulltime

Managed Care Network Administrator

The Muse

Location:
United States , Burlington

Category:
IT - Administration

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Nice to have:

Additional Information:

Job Posted:
May 04, 2026

Expiration:
May 08, 2026

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Location:United States , Burlington

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Job Description:

Job Responsibility:

Requirements:

Nice to have:

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Expiration:May 08, 2026

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Location:
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Category:
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Contract Type:
Not provided

Job Posted:
May 04, 2026

Expiration:
May 08, 2026