Managed Care Finance Director jobs in Somerset, NJ

Managed Care Finance Director directs and oversees all policies and procedures for the financial and data operations of managed care contracts. Manages contracts, negotiates and sets rates, and reviews reimbursement levels and managed care agreements to ensure that proper payment practices are utilized. Being a Managed Care Finance Director implements processes that encourage and inform the organization how to increase levels of reimbursements. Requires a bachelor's degree. Additionally, Managed Care Finance Director typically reports to top management. The Managed Care Finance Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. To be a Managed Care Finance Director typically requires 5+ years of managerial experience. (Copyright 2024 Salary.com)

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Managed Care Specialist
  • Everest National Insurance Company
  • Warren, NJ FULL_TIME
  • Title: Managed Care Specialist Company: Everest Insurance Company Job Category: Claims Job Description: Everest Group, a NYSE listed S&P 500, is a leading global reinsurance and insurance provider, operating for nearly 50 years, now in over 15 countries. Everest is a growth company offering Property, Casualty and Specialty products. We have extensive product and distribution capabilities backed by a strong balance sheet which is evident in our Financial Agency Ratings of: A A. M. Best, A S&P Global and A1 Moody’s Investor Service. We take pride in being known in the industry as nimble, entrepreneurial and responsive. Our culture is innovative, we empower our employees to make business decisions within our risk framework at a local level. At Everest, we are committed to the development of our people. We offer dynamic training & professional development to our employees. You will benefit from career development and learning opportunities that will let you set career goals and fulfill them, including: • Generous tuition/continuing education reimbursement • Mentoring opportunities • Flexible work arrangements • Talent development initiatives • Networking groups PRIMARY PURPOSE: Analyze complex or technically difficult managed care issues to positively impact overall medical costs for all Everest Insurance workers’ compensation business. Provide analytics, strategy and execution for maximum medical cost savings, ensure ongoing adjudications within company claim best practice standards, industry best practices and specific Everest Insurance service instructions; perform analysis of medical bills and data analytics. ESSENTIAL FUNCTIONS and RESPONSIBILITIES: Analyze workers’ compensation costs for reducing medical exposure Develop and manage cost driver action plans Assist in the expansion of managed care services nationally Provide medical management expertise for complex cases Present at internal training workshops Provide excellent customer service internally and externally Conduct ongoing assessment of managed care vendors for optimum performance and medical cost savings Focus on innovation, creativity, original thinking and resourcefulness to achieve financial results Ability to work independently or as a co-leader of various task teams, thrive on change, and have vision for supporting company growth and profitability EXPERIENCE SKILLS and KNOWLEDGE: Five years plus workers’ compensation managed care experience Experience with multi-state fee schedule, inpatient facility and PPO contracts Computer proficiency in all Microsoft Office products with a strong emphasis on Excel In depth knowledge of state workers’ compensation laws Bill review knowledge preferred Excellent oral & written skills Analytical & interpretive skills; excellent judgment, troubleshooting, problem solving skills Ability to handle multiple tasks and deadlines EDUCATION: Bachelor’s Degree from an accredited college or university For CA only: The base salary range for this position is $100,000 - $115,000 annually. The offered rate of compensation will be based on individual education, experience, qualifications and work location. Our Culture At Everest, our purpose is to provide the world with protection. We help clients and businesses thrive, fuel global economies, and create sustainable value for our colleagues, shareholders and the communities that we serve. We also pride ourselves on having a unique and inclusive culture which is driven by a unified set of values and behaviors. Click here to learn more about our culture. Our Values are the guiding principles that inform our decisions, actions and behaviors. They are an expression of our culture and an integral part of how we work: Talent. Thoughtful assumption of risk. Execution. Efficiency. Humility. Leadership. Collaboration. Diversity, Equity and Inclusion. Our Colleague Behaviors define how we operate and interact with each other no matter our location, level or function: Respect everyone. Pursue better. Lead by example. Own our outcomes. Win together. All colleagues are held accountable to upholding and supporting our values and behaviors across the company. This includes day to day interactions with fellow colleagues, and the global communities we serve. #LI-Hybrid #LI-CK1 Type: Regular Time Type: Full time Primary Location: Warren, NJ Additional Locations: Walnut Creek, CA Everest is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion or creed, sex (including pregnancy), sexual orientation, gender identity or expression, national origin or ancestry, citizenship, genetics, physical or mental disability, age, marital status, civil union status, family or parental status, veteran status, or any other characteristic protected by law. As part of this commitment, Everest will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact Everest Benefits at everestbenefits@everestglobal.com. Everest U.S. Privacy Notice | Everest (everestglobal.com) EVEREST is a leading international reinsurance and insurance group with an extensive distribution network that spans five continents. With roots dating back to 1973, Everest has developed a global footprint and deep client relationships that are largely unmatched by its peers. The Company’s principal business strategies seek to leverage its strengths to optimize returns over the underwriting cycle, thereby creating value for its shareholders and business partners.
  • 1 Month Ago

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Vice President, Corporate Accounts
  • Finance
  • Somerset, NJ FULL_TIME
  • Terumo Medical Corporation (TMC) develops, manufactures, and markets a complete, solutions-based portfolio of high-quality medical devices used in a broad range of applications for numerous areas of t...
  • 11 Days Ago

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Senior Director, Finance
  • Cellares
  • Bridgewater, NJ FULL_TIME
  • Position Summary We are seeking a highly motivated Senior Director of Finance who will provide financial leadership to the Cellares Operations and Commercialization organizations and lead the building...
  • 20 Days Ago

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Automotive Finance Director
  • Ciocca Automotive
  • Flemington, NJ FULL_TIME
  • ***WORK FOR THE LARGEST PRIVATELY HELD AUTOMOTIVE DEALER GROUP IN THE TRI-STATE AREA!*** We are actively looking to add an experienced Automotive Finance Director to our growing team at Audi/Volkswage...
  • Just Posted

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Automotive Finance Director
  • Ciocca Dealerships
  • Flemington, NJ FULL_TIME
  • ***WORK FOR THE LARGEST PRIVATELY HELD AUTOMOTIVE DEALER GROUP IN THE TRI-STATE AREA!*** We are actively looking to add an experienced Automotive Finance Director to our growing team at Audi/Volkswage...
  • Just Posted

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Assistant Director of Finance
  • THE ARC OF SOMERSET COUNTY - Manville, N.J.
  • Manville, NJ FULL_TIME
  • JOB TITLE: Assistant Director of Financial Services DEPARTMENT: Finance IMMEDIATE SUPERVISOR: Director of Finance CATEGORY OF EMPLOYMENT / STATUS: Administrative CATEGORY OF EMPLOYMENT / CLASSIFICATIO...
  • 1 Day Ago

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0 Managed Care Finance Director jobs found in Somerset, NJ area

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Chief Finance Officer (CFO)
  • Tandym Group
  • New York, NY
  • A Federally Qualified Health Center (FQHC) in New York is currently seeking an experienced Finance professional to join ...
  • 4/25/2024 12:00:00 AM

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Chief Finance Officer (Healthcare)
  • Callen-Lorde Community Health Center
  • New York, NY
  • Job Description Job Description Are you ready to make a profound impact on the world of LGBTQ+ healthcare and lead a dyn...
  • 4/25/2024 12:00:00 AM

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Controller CFO
  • Raymond Alexander Associates and RAA Temps LLC
  • Hackensack, NJ
  • Job Description Job Description Controller CFO $120-140,000 Hackensack NJ Construction Industry Reporting to the preside...
  • 4/25/2024 12:00:00 AM

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Chief Finance Officer (CFO)
  • Tandym Group
  • New York, NY
  • A Federally Qualified Health Center (FQHC) in New York is currently seeking an experienced Finance professional to join ...
  • 4/22/2024 12:00:00 AM

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Finance Director
  • IDEX Corporation
  • Rutherford, NJ
  • If you're looking for a special place to build or grow your career, you've found it. Whether you're an experienced profe...
  • 4/22/2024 12:00:00 AM

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US Broker Dealer Controller / Deputy CFO
  • Financial Executives International
  • New York, NY
  • **US Broker Dealer Controller / Deputy CFO** Citigroup New York , NY 10176 The Finance Acctg Sr Group Manager manages mu...
  • 4/22/2024 12:00:00 AM

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Administrative Assistant ll, CFO
  • Estee Lauder Companies
  • New York, NY
  • Description Position Summary Provide administrative support for the office of the CFO. Help to effectively manage and or...
  • 4/21/2024 12:00:00 AM

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Executive Assistant to the Business Administrator/CFO
  • Bucks County Intermediate Unit
  • Doylestown, PA
  • JOB DESCRIPTION: Job Summary: The Executive Assistant to the Director is responsible for performing a variety of duties ...
  • 4/21/2024 12:00:00 AM

Somerset is an unincorporated community and census-designated place (CDP) located within Franklin Township, in Somerset County, New Jersey, United States. As of the 2010 United States Census, the CDP's population was 22,083. Somerset housed one of the first Marconi Wireless Stations in the United States. According to the United States Census Bureau, the CDP had a total area of 6.444 square miles (16.692 km2), including 6.327 square miles (16.388 km2) of land and 0.117 square miles (0.304 km2) of water (1.82%)....
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Finance Director jobs
$160,325 to $207,161
Somerset, New Jersey area prices
were up 1.5% from a year ago

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