Manager Managed Care Job at CHRISTUS Health (Irving)

Managed Care Manager - Contracts

Corporate level manager responsible for deploying and contributing to strategic ...

Location

Hollywood

Salary:

Not provided

Memorial Healthcare System

Expiration Date

Until further notice

Requirements

Bachelors (Required)
5 years contracting experience with 3 years contracting for hospital, professional services, ancillary facilities or specialty networks

Job Responsibility

Execute and manage legal, financial and operational contract language negotiations in concert with the Director of Managed Care
Contribute and coordinate negotiations of ancillary services in concert with the Director of Managed Care
Enhance, estimate and preserve net revenues and build market share
Escalate, monitor and manage operational issues from Managed Care Revenue Optimization, Accounts Receivable Management or Joint Operations
Address all single-case negotiations with non-contracted payors
Respond to insurance industry activities, healthcare reform, payer strategies, emerging market demands and legislative considerations

Fulltime

Managed Care Senior Manager

Corporate level manager responsible for deploying and contributing to strategic ...

Location

United States , Fort Lauderdale

Salary:

Not provided

Memorial Healthcare System

Expiration Date

Until further notice

Requirements

Bachelors
Five (5) years contracting experience with three (3) years contracting for hospital, professional services, ancillary facilities or specialty networks

Job Responsibility

Execute, contribute and manage complex legal, financial and operational contract language negotiations in concert with the Director of Managed Care or independently as applicable to the negotiation
Execute contracting strategies for all service lines in Memorial Hospitals, MHS employed physicians, transplant programs, and ancillary services of the fully integrated healthcare delivery system and its joint owned or joint ventured entities for fee for service and value based arrangements
Direct and analyze financial performance, reports and models, quality metrics and cost savings for negotiations with national and regional payors
Plan and monitor activities of staff and team members including hiring, orienting, training, mentoring, continuing education, evaluating, coaching and disciplinary actions
Enhance, estimate and preserve net revenues
Assure financial viability of contracts through financial analysis and forecasting in conjunction with Financial Analyst(s), contract negotiations and issue resolution
Execute strategies and guides operations to protect and build market share
Interface with managed care plans on claim reconciliations, trended issues and operational projects
Determine root cause and seek resolution
Evaluate payor assessments of overpayments and effectively dispute or resolve for settlement

Fulltime

Registered Care Manager - Extra Care Housing

We are seeking an experienced and dynamic Registered Care Manager to lead and ov...

Location

United Kingdom , Kendal and Penrith

Salary:

38000.00 - 40000.00 GBP / Year

360 Resourcing Solutions

Expiration Date

Until further notice

Requirements

NVQ Level 5 in Health & Social Care (or equivalent)
Minimum 3 years in care management, including staff recruitment, supervision, and performance management
Strong understanding of regulatory requirements and best practice in extra care services
Excellent leadership, communication, and organisational skills
Ability to manage budgets, oversee health & safety, and handle complex operational challenges
Access to a vehicle and willingness to travel between sites
Strong understanding and lead in CQC and health and social care governance

Job Responsibility

Take full responsibility for delivering high-quality care services within budget
Provide strong leadership and support to Assistant Managers and staff teams
Drive continuous improvement and maintain a minimum “Good” rating with CQC
Lead on implementing the company’s business plan and quality assurance systems
Represent the company positively at external meetings and with regulatory bodies

What we offer

Refer a Friend Bonus: Earn £125 for both you and your referral (T&Cs apply)
Quarterly & Annual Awards: Celebrate your dedication with our Carer Awards
Blue Light Card: Enjoy retail discounts — we’ll cover the cost!
Employee Assistance Programme: Free, confidential support for you and your family
Mileage Allowance & Toll/Bridge/Tunnel Costs Covered
Free Uniform & Infection Control Equipment
People & Wellbeing Team: A dedicated team focused on your growth and welfare
Comprehensive Training & Career Development: Fast-track training, paid induction, and shadowing opportunities — plus pathways for progression
Sustainability Commitment: We’ve reduced our carbon emissions by 88.8% since 2019 and are on track to achieve Net Zero by 2030
Weekly Pay / Stakeholder Pension Plan

Fulltime

RN Care Manager - Cabarrus Clinical Care Management

RN Care Manager position in Clinical Care Management. Full time, Monday through ...

Location

United States , Concord

Salary:

37.50 - 56.25 USD / Hour

Advocate Aurora Health

Expiration Date

Until further notice

Requirements

BSN required
Masters preferred
Current RN license or temporary license as a Registered Nurse Petitioner in the state in which you work and reside
Two years' experience required in health care
Experience includes case management/discharge planning in one of the following settings: Acute care, Home care, LTC care, Physician Office, or Managed Care company
Appropriate professional certification required within 3 years of hire date
Clinical competence in disease management and case management principles
Must possess excellent interpersonal communication and negotiation skills, problem-solving skills, strong organizational and time management skills, and the ability to work independently and as a member of the care team
Requires demonstrated knowledge and proficiency in appropriate tools
BLS required per policy guidelines

Job Responsibility

Utilizes RN process as a framework to focus the activities of the healthcare team on the achievement of optimal outcomes, resource utilization, clinical expertise, and improvement strategies
Interacts with patients, professionals, and the community to achieve continuity of care, coordination of services and to document plans of care across multiple care settings
Conducts or participates in comprehensive “all-system” needs assessment for identified patients
knowledgeable of appropriate care-related services to match identified needs disease management for health maintenance, and appropriate clinical goal expectations/outcomes for identified population
Develops and maintains accurate case records of each referred customer/patient
Documents fully and accurately
knowledgeable of and utilizes accurate computer databases and documentation systems
Maintains knowledge of various reimbursement criteria and documentation necessary for reimbursement, including Medicaid, Medicare, and Managed Care
Demonstrates leadership in the professional practice of nursing evaluating his or her own nursing practice in relation to professional practice standards and guidelines, relevant statues, rules and regulations

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program
Premium pay such as shift, on call, and more
Incentive pay for select positions
Opportunity for annual increases based on performance

Fulltime

Clinical Nurse Manager 2 or Social Care Manager 2

TTM Healthcare are currently recruiting a Clinical Nurse Manager 2 or Social Car...

Location

Ireland , Athlone, Kilteevan, Roscommon Town

Salary:

Not provided

TTM Healthcare

Expiration Date

Until further notice

Requirements

A relevant 3rd level qualification in Nursing and current Live Register Certificate from NMBI
Be registered, or be eligible for registration, on the Social Care Workers Register maintained by the Social Care Workers Registration Board at CORU
Hold a schedule 3 qualification
Hold a comparable qualification recognised by Social Care Workers Registration Board at CORU
Applicants who satisfy the conditions set out in Section 91 of the Health and Social Care Professionals Act 2005 must submit proof of application for registration with the Social Care Workers Registration Board at CORU
Hold an appropriate qualification in Health and Social Care Management (QQI Level 6) is a necessary requirement of the post. If the successful applicant does not hold such a qualification, a commitment to obtaining the qualification prior to taking up the post will be required
A minimum of three 3 years' post qualification experience, working with people with an Intellectual Disability is essential

Job Responsibility

Developing existing services through supporting the local staff teams
Person in Charge (PIC) responsibility
Oversee some residential and day service locations
An on-call commitment on a 7-day rostered basis

What we offer

Incremented pay scales
Pension
Maternity pay
Excellent support
Career progression opportunities
Monday to Friday working hours

Fulltime

Patient Care Manager I (RN Required)- Ambulatory Care Tri-Valley

This is a high-impact operational and clinical leadership role responsible for e...

Location

United States , Pleasanton

Salary:

89.01 - 117.94 USD / Hour

Stanford Health Care

Expiration Date

Until further notice

Requirements

Bachelor and/or Master in Nursing from an accredited college or university
Three (3) years of progressively responsible and directly related work experience
RN - Registered Nurse - State Licensure And/Or Compact State Licensure
Ability to contribute to health care policy formulation when working in partnership with a multidisciplinary team of health care providers
Ability to delegate responsibly to others, activities according to ability, level of preparation, the standards of practice and regulatory guidelines
Ability to develop programs and lead process improvement projects
Ability to establish the strategic direction and business plans for a functional group
Ability to initiate and implement change conducive to the improvement of the quality and safety of patient care delivery
Ability to provide leadership, influence others to meet patient needs and achieve shared goals, to effectively prioritize system resources to provide quality and valued patient care, promote cooperative behaviors, act as a role model, resource and mentor
Ability to supervise, coach, mentor, train, and evaluate work results

Job Responsibility

Clinical Practice: Ensures the effective delivery of competent, compassionate, and efficient patient care by planning, organizing, and directing the nursing services of unit(s), including the assessment of patients, implementation of physicians' orders, treatment plans and medical procedures, administration of medication and record keeping of same as well as by monitoring and evaluating patient care processes and outcomes for the patient care unit(s)
coordinates nursing activities with those of other services or disciplines
Communication: Communicates in a clear and effective manner to enhance team effectiveness, manage conflicts, engage employees and interdisciplinary colleagues in unit activities and performance changes
collaborates with others within the unit and with all hospital departments and disciplines to enhance problem solving, decision making and performance improvement
Fiscal Accountability: Plans and forecasts the department budget by calculating required FTES, planning annual budgets, interpreting payroll and other key fiscal reports, projecting workload as well as monitoring and enhancing productivity
performs variance analysis by interpreting financial performance and identifying key drivers
identifies unit/capital budget needs in collaboration with physician and nursing colleagues
plans and implements staff scheduling, position controls and attendance control procedures
Human Resources: Directs the personnel management of the employees assigned to the department consistent with state and federal labor laws, collective bargaining agreements, and nursing service and hospital philosophy, goals and policy
ensures that new staff is interviewed, hired, trained, oriented, precepted and evaluated

Fulltime

Personal Care ID Asst. Innovation Planning Manager Oral Care

Location

Indonesia , Banten

Salary:

Not provided

Unilever

Expiration Date

Until further notice

Requirements

Able to operate Microsoft Project
Able to manage complexity in the project
Engineering background is preferred (chemical and industrial engineering is preferred)
Experience as PMO is value added
Strong end to end business understanding
Improvement process oriented
Able to work as a team and lead a team
Able to drive related business partner
Strong negotiation skill

Job Responsibility

Understand and could drive Project Network deliveries
Understand end to end Product Innovation activities
Construct Volume Projection of New Product and analyze the achievement
Regularly review process and continuously improve process through automation
Seek additional information from business partner
Connect & negotiate with supplier on MOQ and Optimum on timing delivery

Fulltime

Global Fragrance and Oral Care Flavors Portfolio Assistance Procurement Manager Personal Care

This role is part of Procurement’s Sourcing team, which is responsible for leadi...

Location

India , Mumbai

Salary:

Not provided

Unilever

Expiration Date

Until further notice

Requirements

Procurement Sourcing Strategy (level 2 - Capable)
Supplier Analysis (level 3 - Intermediate)
Value Chain Understanding (level 3 - Intermediate)
Supplier Negotiation (level 3 - Intermediate)
Contract Negotiation (level 2 - Capable)
Sourcing Resilience (level 3 - Intermediate)
Stakeholder Management (level 3 - Intermediate)
Strategic Partnerships (level 3 - Intermediate)
Collaboration (level 3 - Intermediate)
Program Management (level 3 - Intermediate)

Job Responsibility

You are a strategy Champion: You lead the co-creation of the innovation agenda for your portfolio. You monitor and understand the dynamically changing consumer market, ensuring a future fit trend driven portfolio, delivering desirability at scale and affordable superiority. With a focus on emerging technologies, you lead the development of not only the current portfolio, but future capabilities.
You are external facing and an expert in the supplier landscape: You assess, identify, and select the appropriate supplier base that meet the needs of the business. You ensure and manage overall performance of suppliers and surpass stakeholder needs.
You take considered decisions under pressure: You handle complex and diverse customer, supplier, supply chain or operational issues within generally defined practices and policies in selecting methods and techniques for obtaining solutions.
You are a leader: You are a leader of procurement projects in your portfolio and for your materials. You take on a role leading portfolio wide activity such as accurate price forecasting and complexity reduction.
You are a storyteller: You use your strategic influencing skills to drive Procurement considerations and strategic recommendations with Stakeholders.
You create growth for Unilever: You work closely with Brand, R&D, Supply Chain, Strategy and Insights and Category Procurement teams to support the launch of innovations and new product development.
You achieve key financial targets: Delivering the business financial targets for Buying Performance, Product Superiority and Complexity reduction for the portfolio materials/services and suppliers. You prepare information on purchase prices and conditions to enable proper budgeting and cash forecasting.

Fulltime

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