Managed care contracting jobs in Bayonne, New JerseyCreate job alerts

Key Responsibilities Develop and execute national payer contracting strategy focused on value-based and full-risk arrangements Lead national payer relationships, including negotiation and performance oversight with health plans Oversee credentialing operations and drive payer performance managem

Provider Engagement and Performance Manager The Provider Engagement and Performance Manager plays a critical role in advancing Network Solutions IPA’s (NSIPA) mission by developing, managing, and supporting a high-performing provider network. This role is responsible for fostering strong provider relationships, driving performance in value-based care contracts, and ensuring provider satisfaction through effective engagement, education, and administrative support. The ideal candidate is proactive, mission-driven, customer-focused, and thrives in a fast-paced healthcare environment. They possess strong communication and analytical skills, a collaborative spirit, and a deep understanding of provider practice operations and value-based care delivery models. Key Responsibilities Provider Engagement, Performance & Relationship Management • Serve as the primary point of contact for a panel of providers within a designated territory., • Represent and promote NSIPA as the preferred IPA through strong provider relationships and superior service., • Conduct regular in-person provider visits (3–4 days/week) and manage follow-up activities on administrative days (1–2 days/week)., • Lead new provider onboarding and orientations, ensuring a smooth introduction to NSIPA's programs, policies, and value-based contracts., • Communicate performance expectations, program updates, and support resources in a clear and timely manner., • Collaborate with providers to implement quality improvement initiatives and care gap closure strategies., • Provide practices with performance reports and actionable insights, including quality metrics, care gap data, and population health dashboards., • Analyze provider performance from a clinical, operational, and financial perspective to identify opportunities for improvement., • Support access to EMRs, assist with medical record requests, and gather provider cooperation for performance initiatives., • Identify opportunities to expand or strengthen NSIPA’s provider network in alignment with strategic goals., • Assist with provider recruitment and engagement strategies in partnership with payers and internal stakeholders., • Develop an in-depth understanding of the unique needs and challenges of NSIPA’s provider network., • Support planning and execution of provider meetings, events, and educational seminars., • Work closely with internal teams across departments (e.g., Quality, Care Coordination, Contracting, IT) to ensure successful implementation of NSIPA initiatives., • Participate in Joint Operating Committee (JOC) meetings and collaborate with payers as needed., • Ensure timely resolution of provider issues, inquiries, or concerns, maintaining a high level of service and satisfaction., • Maintain accurate and up-to-date records of provider contacts, staffing, and key operational information., • Ensure the quality and completeness of documentation, including onboarding packets, orientation materials, and performance reports., • Assist with special projects and organizational initiatives, such as events, chart chases, EMR integration, or population health efforts. Skills & Competencies • Excellent interpersonal and communication skills, with the ability to build trust-based provider relationships., • Strong critical thinking and problem-solving abilities., • Self-motivated, organized, and able to manage competing priorities., • Proficiency in Microsoft Office Suite and other relevant software platforms., • A collaborative, entrepreneurial mindset aligned with NSIPA’s mission and provider-first philosophy. Core Attributes • Mission-driven and customer service-oriented, • Strong sense of ownership and accountability, • Analytical mindset with the ability to interpret data for actionable insights, • Entrepreneurial spirit with a proactive approach to solving problems, • High level of professionalism, integrity, and emotional intelligence Education & Experience • Bachelor’s degree in healthcare administration, public health, business, or a related field (Master’s preferred)., • 3+ years of experience in provider relations, network management, or a similar healthcare-facing role., • Knowledge of value-based care, managed care models, and healthcare provider operations., • Experience working with EMRs, performance reporting tools, and population health platforms is a plus. NSIPA is proud to be an equal opportunity employer and values diversity in our network and workplace.

Job DescriptionSenior Oracle APEX DeveloperEmployment Type: Full-Time, Entry-Mid LevelDepartment: Information Technology CGS is hiring a Senior Oracle APEX Developer to support a range of IT services, including software application support, enterprise infrastructure support, service desk, ITSM, deskside support, workstation engineering and maintenance, telecommunications and mobility engineering services, managed print services, Active Directory services, and video conferencing. The ideal candidate will be personable and articulate and will focus on making sure that the customer’s needs are met quickly and effectively. The successful candidate will be a self-starter who can work with limited supervision. Excellent communication skills are required to effectively interface with customers to understand requirements and mission needs, and then be able to translate them into actions. CGS brings motivated, highly skilled, and creative people together to solve the government’s most dynamic problems with cutting-edge technology. To carry out our mission, we are seeking candidates who are excited to contribute to government innovation, appreciate collaboration, and can anticipate the needs of others. Here at CGS, we offer an environment in which our employees feel supported, and we encourage professional growth through various learning opportunities. Skills and attributes for success- Work at the direction of the program manager to support the full lifecycle development of custom Oracle Applications, primarily using the Oracle APEX toolset.- Perform advanced use of Oracle APEX 4.0 and above.- Perform work with Oracle Integrated Development Environments such as Quest Toad and Oracle SQL Developer.- Design and manipulate web content dynamically using JQuery, Ajax, JavaScript, CSS, and HTML.- Create dynamic reports within the Oracle APEX environment. Provide support in the advanced use of Oracle Database products version 11 and above.- Provide support for Oracle database objects – tables, indexes, directories, sequences, triggers, etc.- Provide support with PL/SQL, Java, Windows PowerShell, and Unix shell scripting with familiarity with built-in PLSQL packages and procedures.- Provide support with storage, efficient retrieval, and manipulation of unstructured data (BLOBs, CLOBs, JSON, XMLType) in an Oracle environment.- Integrate and manage BI Publisher templates and web Services.- Successfully deliver enterprise-level workflow-centric applications.- Build logical functions and algorithms to automate business processes. Qualifications- Bachelor’s degree with 8+ years experience. A High School diploma with additional years of experience and/or relevant certifications may be considered in lieu of a degree.- U.S. Citizen.- Ability to obtain and maintain a public trust security clearance.- Experience with secure network programming in an Oracle environment; use of security certificates, HTTPS callouts, etc.- Experience with full lifecycle development of custom Oracle Applications, including the Oracle APEX toolset.- Experience with the use of Oracle Integrated Development Environments such as Quest Toad and Oracle SQL Developer.- Experience with JQuery, Ajax, JavaScript, CSS, and HTML.- Experience with PL/SQL, Java, Windows PowerShell, and Unix shell scripting with familiarity with built-in PLSQL packages and procedures.- Experience with storage, efficient retrieval, and manipulation of unstructured data (BLOBs, CLOBs, JSON, XMLType) in an Oracle environment.- Experience establishing goals and meeting project plan objectives.- Must be able to write and maintain system documentation on work products.- Excellent communication and teamwork skills.- Agile development experience.- Customer interface experience. Ideally, you will also have: - Experience with Oracle Database products version 11 and above.- Experience with Oracle Forms and Reports version 10G or higher.- Experience with Oracle APEX 4.0 and above.- Experience troubleshooting operational issues.- Government contracting experience, particularly with the DOJ.- Current DOJ Clearance. Our Commitment : Contact Government Services (CGS) strives to simplify and enhance government bureaucracy through the optimization of human, technical, and financial resources. We combine cutting-edge technology with world-class personnel to deliver customized solutions that fit our client’s specific needs. We are committed to solving the most challenging and dynamic problems. For the past seven years, we’ve been growing our government contracting portfolio, and along the way, we’ve created valuable partnerships by demonstrating a commitment to honesty, professionalism, and quality work. Here at CGS we value honesty through hard work and self-awareness, professionalism in all we do, and to deliver the best quality to our consumers mending those relations for years to come. We care about our employees. Therefore, we offer a comprehensive benefits package.- Health, Dental, and Vision- Life Insurance- 401k- Flexible Spending Account (Health, Dependent Care, and Commuter)- Paid Time Off and Observance of State/Federal Holidays Contact Government Services, LLC is an Equal Opportunity Employer. Applicants will be considered without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Join our team and become part of government innovation! Explore additional job opportunities with CGS on our Job Board: For more information about CGS please visit: or contact:Email: #CJ We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

Job DescriptionAutomated Litigation Support Lab Manager Employment Type: Full-Time, ExperiencedDepartment: Finance As a CGS ALS Lab Manager, you will leverage industry knowledge, and market research, and have wide-ranging experiences across operating systems and coding languages. You will serve as the lead manager responsible for the delivery of lab data processing services and be responsible for ensuring that incoming productions are made pursuant to the applicable ESI specifications and providing the case attorney with detailed notice of deficiencies. CGS brings motivated, highly skilled, and creative people together to solve the government’s most dynamic problems with cutting-edge technology. To carry out our mission, we are seeking candidates who are excited to contribute to government innovation, appreciate collaboration, and can anticipate the needs of others. Here at CGS, we offer an environment in which our employees feel supported, and we encourage professional growth through various learning opportunities. Skills and attributes for success:- Serves as the lead manager responsible for delivery of lab data processing services.- Primarily ensures timely and accurate completion of tasks. Performs analysis, development and implementation of processing approaches for electronic files and related services pursuant to applicable ESI specifications.- Consults with attorneys and support staff on best practices for conforming to ESI specifications and, as required, participates in teleconferences with co-counsel, client agencies, and opposing counsel upon attorney request.- Responsible for ensuring that incoming productions are made pursuant to the applicable ESI specifications and when deficiencies are found, provides case attorney with detailed notice of deficiencies.- Responsible for keeping the client informed on activities in the Lab, e.g. deadlines, technical challenges, and availability of resources to complete work. - Responsible for webhosting support for unsupported cases managed by the lab.- Manages a team of eDiscovery professionals situated in a client-site eDiscovery laboratory, including: scheduling, requirements assessments, assigning work and ensuring deadlines are met, creating progress reports, and Quality Control (QC) of deliverables.- Advises client attorneys, paralegals, and case managers on all phases of the Electronic Discovery Reference Model (EDRM); especially: Data Collection, Processing, Hosting, Review, Analytics, and Production. Qualifications:- Extensive Relativity experience required.- Relativity certifications including Relativity Certified Administrator (RCA) and/or Relativity Analytics Specialist strongly preferred.- At least eight years of experience performing eDiscovery roles including but not limited to electronic files processing (EFP), image and data file conversion, data culling using review tools, quality assurance, database loads and retrieval, and data analysis and review.- At least five years of experience at the management/supervisory level.- Requires thorough knowledge of the litigation discovery process, and the EDRM workflow.- Working knowledge and certifications of document review software such as iConect, Relativity, Venio or similar tools.- Undergraduate degree required, preferably in computer science or related field. Only the Contracting Officer can approve a waiver of the degree requirement. Ideally, you will also have:- Experience with litigation support tools such as LAW, IPRO, Concordance, MS Office Suite, and LiveNote highly valued. Our Commitment:Contact Government Services (CGS) strives to simplify and enhance government bureaucracy through the optimization of human, technical, and financial resources. We combine cutting-edge technology with world-class personnel to deliver customized solutions that fit our client’s specific needs. We are committed to solving the most challenging and dynamic problems. For the past seven years, we’ve been growing our government-contracting portfolio, and along the way, we’ve created valuable partnerships by demonstrating a commitment to honesty, professionalism, and quality work.Here at CGS we value honesty through hard work and self-awareness, professionalism in all we do, and to deliver the best quality to our consumers mending those relations for years to come. We care about our employees. Therefore, we offer a comprehensive benefits package.- Health, Dental, and Vision- Life Insurance- 401k- Flexible Spending Account (Health, Dependent Care, and Commuter)- Paid Time Off and Observance of State/Federal Holidays Contact Government Services, LLC is an Equal Opportunity Employer. Applicants will be considered without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Join our team and become part of government innovation!Explore additional job opportunities with CGS on our Job Board: more information about CGS please visit: or contact:Email: #CJ We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

Job Description Come join an exciting and innovative company that puts the “care” back in healthcare! Why do Contracts Managers want to work here? The reason people love working for KabaFusion is because of the impact we have on our patients. Here, it doesn’t matter what your role is, you will be part of a team that works collaboratively to change lives. You will go home knowing you’ve made a difference and improved someone’s life. About Us: What started as a single pharmacy in 2010 has grown into KabaFusion becoming the largest privately held home infusion company in the country. We have a national network of pharmacies and nursing offices strategically placed to service 40+ states. Couple that with over 30 years of combined experience and it’s no wonder why KabaFusion is the industry leader in home infusion. About the role: As the Contracts Manager, you are responsible for the oversight of KabaFusion’s managed care contracts. If this sounds like a big role, it is. You will be on the front line when it relates to contract negotiations / re-negotiations, maintaining knowledge and understanding of various payor products along with their Division of Financial Responsibility and, when necessary, act as the liaison between KabaFusion and the payor. Essential Duties & Responsibilities: • Routinely review contract language and pricing, • Recommend and implement cost reduction measures for the provision of ancillary services, • Maintain and update managed care manuals and contracts, • Assist with the creation of and implementation of managed care policies and procedures As a Contracts Manager, you bring: • Bachelor's degree or equivalent experience, • 7+ years of experience in the healthcare industry, home infusion experience is a plus, • 3+ years of managed care contracting experience, • 3+ years of management / supervisory experience Compensation: Our Benefits: • Benefits start on your 1st day of employment., • 401k w 4% match – no waiting or vesting period, • PTO / Floating Holidays / Paid Holidays, • Company paid life insurance and short-term disability, • Employee Assistance programs to help with mental health / wellness, • Learning & Development Programs, • Perks… includes discounts on travel, cell phone, clothing and more…, • Generous employee referral program KabaFusion is a mission driven company with a focus on innovation and patient care so, as a Contracts Manager, if that sounds like something you want to be a part of, then look no further.

Job Description Overview Area Vice President (AVP) of Business Development – Northeast Region The Area Vice President (AVP) of Business Development – Northeast Region is responsible for identifying and pursuing new business opportunities to drive growth and revenue across the Northeast territory, which includes New York, New Jersey, Connecticut, Rhode Island, and Maine. The AVP leads a team of Account Managers and collaborates closely with the Regional Vice President (RVP) of Business Development to develop and execute effective strategies that expand market presence and achieve organizational growth objectives. This includes market analysis, competitor research, and partnership development throughout the assigned region. The AVP also supports the negotiation and closing of new business deals, manages key client relationships, and ensures a high level of customer satisfaction. This role plays a vital part in maintaining the company’s reputation for excellence while driving measurable growth in the Northeast market. Key Skills and Attributes: • Strong analytical and strategic planning abilities, • Exceptional communication, presentation, and negotiation skills, • Proven leadership experience in business development or healthcare sales management, • Ability to build, motivate, and guide high-performing teams, • Deep understanding of market dynamics within the Northeast healthcare industry Responsibilities • Implements the sales and marketing strategies to grow and expand the Home Health business in assigned area, • Directs the implementation of sales strategy through discussions with the area business development team, • Monitors and maintains data on market area including competitors and marketing strategies and works with the RVP of Business Development to develop a comprehensive marketing plan designed to meet budgetary volume projections, • Manages and directs the area business development team in planning in-services, presentations, and addressing issues with referral sources, • Initiates and coordinates contract negotiations with agencies, funding sources, facilities, insurance companies, and managed care organizations, • Supports and promotes company philosophy to referral sources in the community, • Develops and maintaining comprehensive working knowledge of organization's markets including but not limited to key referral sources, competitors, governmental agencies, and major payer groups and applies this knowledge to effective sales planning and positive public relations, • Monitors current industry and marketplace changes and opportunities for competitive advantage, • Participates and contributes to the annual budgeting process for the Home Health Division for the respective area of responsibility, • Holds leaders (business development) and teams accountable for the achievement of monthly, quarterly, and annual budgets and business / clinical quality goals, • Provides leadership, mentoring, coaching and development to direct reports, • Responsible for reporting on plans and achievement of business, admission and clinical / quality goals to division President and Company CEO, • Responsible for recruiting, interviewing, hiring, and training of direct reports, • Monitors turnover in the area of responsibility, • Ensures proper hiring, training, and development of newly hired staff, • Works closely with support departments to achieve routine collaboration with payer contracting to negotiate the strongest contracts, • Monitors metrics proactively to effect change in a positive direction before month end, • Collaborates with business partners and uses appropriate resources to accurately forecast monthly admissions/growth, • Assigned territory and area of operation can change based on business need Qualifications • Bachelor's degree in Marketing, Business Administration or related field, • Ten years experience in hospice and/or home health business development, • Proven success in the development and execution of strategic marketing plans, • Experience in strategic planning and collaboration with executive, sales, product development and key operational groups, • A deep and broad professional network that aligns to our target client base preferred, • Demonstrated track record in building new book of business, client relationship management, and evidence of closing and growing accounts preferred, • Strong analytical, communication, and negotiation skills, • Ability to work with remote teams with units in multiple locations, • Relationship building skills, • Excellent presentation and public speaking and sales skills

Job Description: Vice President of Revenue Cycle Management Position Summary The Vice President of Revenue Cycle Management (RCM) provides executive leadership and strategic direction for all revenue cycle functions across the hospital or health system. This role is responsible for optimizing the end-to-end revenue cycle—patient access, clinical documentation integrity, coding, billing, claims management, reimbursement, and collections—to ensure financial sustainability while supporting high-quality patient care and an exceptional patient financial experience. Salary: • 250k plus bonus., • Contingent on experience. Key Responsibilities Strategic Leadership & Management • Develop and execute the organization’s revenue cycle strategy to support financial goals, regulatory compliance, and operational efficiency., • Lead, mentor, and develop RCM leaders and teams across patient access, HIM/coding, CDI, billing, and collections., • Oversee all revenue cycle operations to ensure accurate, compliant, and timely billing and reimbursement., • Ensure effective processes for insurance verification, authorization, scheduling, registration, and financial counseling., • Partner with the CFO and finance teams to forecast revenue, analyze financial trends, and identify opportunities to improve cash flow., • Develop and manage the revenue cycle budget., • Ensure compliance with federal, state, and payer regulations, including CMS, HIPAA, and hospital accreditation standards., • Oversee audit readiness, including documentation, coding accuracy, and internal controls., • Collaborate with IT to evaluate and optimize RCM systems, workflow tools, and automation solutions., • Work closely with clinical leaders, finance, legal, IT, and operational departments to ensure cohesive workflows and accurate revenue capture., • Partner with managed care contracting teams to support payer negotiations and reimbursement strategies. Qualifications Education • Bachelor’s degree in Business, Finance, Healthcare Administration, or related field required., • 10+ years of progressive leadership in healthcare revenue cycle management, including at least 5 years in a senior or executive role., • Deep knowledge of hospital and physician billing, coding, compliance, and payer regulations., • Strong strategic planning and organizational leadership skills., • Expertise in revenue cycle KPIs, analytics, and benchmarking., • Excellent communication and relationship-building skills., • Ability to lead change, manage complexity, and leverage technology solutions., • High integrity and commitment to patient-centered financial practices.

Job DescriptionSenior Oracle APEX Developer IIEmployment Type: Full-Time, Entry-Mid LevelDepartment: Information Technology CGS is hiring a Senior Oracle APEX Developer to support a range of IT services, including software application support, enterprise infrastructure support, service desk, ITSM, deskside support, workstation engineering and maintenance, telecommunications and mobility engineering services, managed print services, Active Directory services, and video conferencing. The ideal candidate will be personable and articulate and will focus on making sure that the customer’s needs are met quickly and effectively. The successful candidate will be a self-starter who can work with limited supervision. Excellent communication skills are required to effectively interface with customers to understand requirements and mission needs, and then be able to translate them into actions. CGS brings motivated, highly skilled, and creative people together to solve the government’s most dynamic problems with cutting-edge technology. To carry out our mission, we are seeking candidates who are excited to contribute to government innovation, appreciate collaboration, and can anticipate the needs of others. Here at CGS, we offer an environment in which our employees feel supported, and we encourage professional growth through various learning opportunities. Skills and attributes for success- Work at the direction of the program manager to support the full lifecycle development of custom Oracle Applications, primarily using the Oracle APEX toolset.- Perform advanced use of Oracle APEX 4.0 and above.- Perform work with Oracle Integrated Development Environments such as Quest Toad and Oracle SQL Developer.- Design and manipulate web content dynamically using JQuery, Ajax, JavaScript, CSS, and HTML.- Create dynamic reports within the Oracle APEX environment. Provide support in the advanced use of Oracle Database products version 11 and above.- Provide support for Oracle database objects – tables, indexes, directories, sequences, triggers, etc.- Provide support with PL/SQL, Java, Windows PowerShell, and Unix shell scripting with familiarity with built-in PLSQL packages and procedures.- Provide support with storage, efficient retrieval, and manipulation of unstructured data (BLOBs, CLOBs, JSON, XMLType) in an Oracle environment.- Integrate and manage BI Publisher templates and web Services.- Successfully deliver enterprise-level workflow-centric applications.- Build logical functions and algorithms to automate business processes. Qualifications- Bachelor’s degree with 8+ years experience. A High School diploma with additional years of experience and/or relevant certifications may be considered in lieu of a degree.- U.S. Citizen.- Ability to obtain and maintain a public trust security clearance.- Experience with secure network programming in an Oracle environment; use of security certificates, HTTPS callouts, etc.- Experience with full lifecycle development of custom Oracle Applications, including the Oracle APEX toolset.- Experience with the use of Oracle Integrated Development Environments such as Quest Toad and Oracle SQL Developer.- Experience with JQuery, Ajax, JavaScript, CSS, and HTML.- Experience with PL/SQL, Java, Windows PowerShell, and Unix shell scripting with familiarity with built-in PLSQL packages and procedures.- Experience with storage, efficient retrieval, and manipulation of unstructured data (BLOBs, CLOBs, JSON, XMLType) in an Oracle environment.- Experience establishing goals and meeting project plan objectives.- Must be able to write and maintain system documentation on work products.- Excellent communication and teamwork skills.- Agile development experience.- Customer interface experience. Ideally, you will also have: - Experience with Oracle Database products version 11 and above.- Experience with Oracle Forms and Reports version 10G or higher.- Experience with Oracle APEX 4.0 and above.- Experience troubleshooting operational issues.- Government contracting experience, particularly with the DOJ.- Current DOJ Clearance. Our Commitment : Contact Government Services (CGS) strives to simplify and enhance government bureaucracy through the optimization of human, technical, and financial resources. We combine cutting-edge technology with world-class personnel to deliver customized solutions that fit our client’s specific needs. We are committed to solving the most challenging and dynamic problems. For the past seven years, we’ve been growing our government contracting portfolio, and along the way, we’ve created valuable partnerships by demonstrating a commitment to honesty, professionalism, and quality work. Here at CGS we value honesty through hard work and self-awareness, professionalism in all we do, and to deliver the best quality to our consumers mending those relations for years to come. We care about our employees. Therefore, we offer a comprehensive benefits package.- Health, Dental, and Vision- Life Insurance- 401k- Flexible Spending Account (Health, Dependent Care, and Commuter)- Paid Time Off and Observance of State/Federal Holidays Contact Government Services, LLC is an Equal Opportunity Employer. Applicants will be considered without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Join our team and become part of government innovation! Explore additional job opportunities with CGS on our Job Board: For more information about CGS please visit: or contact:Email: #CJ We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

Job Description Company Overview: Public Health Solutions (PHS) is a 501(c)3 non-profit community-based organization (CBO) that has existed for 70 years to improve health equity and address health-related social needs (HRSN) for historically underserved marginalized communities. As the largest public health nonprofit serving New York City, we improve health outcomes and help communities thrive by providing services directly to vulnerable families, supporting community-based organizations through our long-standing public-private partnerships, and bridging the gap between healthcare and community services. We focus on a wide range of public health issues including food and nutrition, health insurance, maternal and child health, sexual and reproductive health, tobacco control, and HIV/AIDS. Learn more about our work at healthsolutions.org. PHS administers WholeYouNYC (WYNYC), a coordinated community resource network that builds trustworthy and reliable pathways between healthcare providers, health plans and CBOs providing critical resources in the community that address the social drivers of health. WYNYC brings together over 100 organizations offering various programs – such as food, housing, employment, health insurance, and sexual health services – across all five boroughs. These services and programs make it possible for New Yorkers to live their healthiest lives and ultimately reduce health disparities and advance health equity. To date, our network has already impacted thousands of lives through community partnerships and referrals, generating millions in estimated healthcare savings. New York State (NYS) recently announced the availability of $500M statewide to support Social Care Network (SCN) lead entities responsible for coordinating social care delivery in various regions across the state. Public Health Solutions (PHS) and our WYNYC network were awarded the role of regional SCN for Brooklyn, Manhattan, and Queens. This is a grant-funded position ending March 31, 2027. Program Description: Public Health Solutions receives and administers hundreds of millions of dollars from Federal, New York State (NYS), New York City (NYC), and private funding sources to improve public health and human services. PHS administers funds on behalf of external partners as well as internal programs through contracts with small, medium, and large non-profit organizations located in all five boroughs of New York City. Position Summary: Reporting to a Portfolio Manager, the Contract Manager is responsible for all aspects of the contracting processes. We seek an experienced Contract Manager to coordinate with internal and external stakeholders, monitor contractor performance and spending, and provide technical assistance to promote effective program implementation. Specifically, the Contract Manager will have the following key responsibilities: Oversight and Management: • Manage all aspects of the contract lifecycle, including advising on solicitations, negotiating scopes of work and budgets, executing contracts and amendments, conducting ongoing monitoring, and performing closeout duties., • Develop and maintain positive relationships with contractors and internal and external partners, ensuring clear communication of expectations and requirements., • Ensure compliance with funders’ regulations., • Maintain comprehensive contract files and documentation., • During contract negotiation, review and advise on proposed budgets and scopes., • Throughout the contract term, monitor spend-down and adherence to approved budgets. Work with contractors to address any issues or discrepancies and modify budgets as needed and appropriate., • Ensure that expenditure reports submitted by the contractors are accurate, complete, and in compliance with applicable regulations (e.g., Federal 2 CFR 200). This includes but is not limited to reviewing expense invoices and ensuring that costs are allowable, allocable, and reasonable., • In coordination with external and internal partners, review progress reports to track milestones, deliverables, and other performance metrics to ensure the contractor meets its goals and objectives., • Provide guidance to the contractor when appropriate to ensure that the contract is managed in compliance with the terms and regulations. Qualifications and Experience: • Bachelor’s degree or equivalent in public health, public administration, or related program or contract monitoring experience with minimum 3+ years of work experience., • Experience reviewing and negotiating scopes of work, budgets, payment requests, and programmatic data., • Knowledge of post award grant management procedure and public health service provision in non-profit organizations., • Ability to learn quickly, manage multiple obligations, proactively problem-solve, and provide timely and clear updates to supervisors., • Excellent attention to detail, organizational skills, and the ability to manage multiple contracts simultaneously., • Ability to communicate complex information clearly and effectively with stakeholders at all levels., • Ability to manage relationships appropriately and effectively with internal and external stakeholders and contractors for the optimal resolution of contract issues., • Proficiency in Microsoft Office required. Experience with contract lifecycle management systems (e.g., Agiloft) a plus. Benefits: • Hybrid Work Schedule., • Generous Paid Time Off and Holidays., • An attractive and comprehensive benefits package including Medical, Dental and Vision., • Flexible Spending Accounts and Commuter Benefits., • Company Paid Life Insurance and Disability Coverage., • 403(b) + employer matching and discretionary company contributions., • College Savings Plan., • Ongoing trainings and continuous opportunities for professional growth and development. At PHS, we place immense value on diversity within our teams, understanding that varied backgrounds and experiences significantly enhance our community and propel us toward our goals. If you find you don’t have experience in all the areas listed above, we still encourage you to apply and share your background and experiences in your application. We are eager to discover how your unique perspective can bring positive transformations to our team and help advance our mission of creating healthier, more equitable communities. We look forward to learning more about you! PHS is proud to be an equal opportunity employer and encourages applications from women, people of color, persons with disabilities, LGBTQIA+ individuals, and veterans. Monday - Friday 9am-5pm 35 Hours Per Week

Job DescriptionPosition Title: Health Law Practice Group Associate or Special Counsel (PBM)Salary Range: $200,000 to $345,000About the Opportunity Our Health Law Practice is uniquely positioned to guide clients through structural and operational challenges. Our clients include providers (non-profit, publicly traded and private equity backed), payors, manufacturers, distributors, and suppliers. The breadth and depth of our knowledge and experience inform our advice in related litigation and transactional matters. We also draw upon the capabilities of a wide range of related practices within the firm as the need arises. This cross-disciplinary approach allows our attorneys to solve the many problems our clients face while expanding their business opportunities. Key Requirements/Responsibilities Looking for a Practice Group Associate (PGA) or Special Counsel with knowledge of the PBM industry and a minimum of three (3) years of commercial contracting experience in matters related to managed care or the pharmaceutical supply chain to join the Health Law Practice in Boston, New York or Washington, DC. This individual will support a team that advises national and regional health plans, particularly in their contracting relationships with pharmacy benefit managers (PBMs) and other pharmaceutical supply chain vendors. The role involves working on a wide range of commercial agreements and transactions that are central to the pharmacy benefit operations of health plans, payors, PBMs, and other service providers and entities within the health care industry. Candidates with experience in complex commercial and/or transactional matters in the PBM or managed health industry are preferred, particularly those familiar with federal and state regulations of health plans, pharmacy benefit managers, and other pharmaceutical supply chain providers and related entities. Items Needed to Apply: Resume, Cover Letter, Law School Transcript. Confidentiality For confidentiality reasons, the client’s name is not disclosed at this stage. Qualified candidates will receive full details upon initial screening.

The Provider Engagement and Performance Manager play a critical role in advancing Network Solutions IPA’s (NSIPA) mission by developing, managing, and supporting a high-performing provider network. This role is responsible for fostering strong provider relationships, driving performance in value-based care contracts, and ensuring provider satisfaction through effective engagement, education, and administrative support. The ideal candidate is proactive, mission-driven, customer-focused, and thrives in a fast-paced healthcare environment. They possess strong communication and analytical skills, a collaborative spirit, and a deep understanding of provider practice operations and value-based care delivery models. Key Responsibilities · Serve as the primary point of contact for a panel of providers within a designated territory. · Represent and promote NSIPA as the preferred IPA through strong provider relationships and superior service. · Conduct regular in-person provider visits (3–4 days/week) and manage follow-up activities on administrative days (1–2 days/week). · Lead new provider onboarding and orientations, ensuring a smooth introduction to NSIPA's programs, policies, and value-based contracts. · Communicate performance expectations, program updates, and support resources in a clear and timely manner. · Collaborate with providers to implement quality improvement initiatives and care gap closure strategies. · Provide practices with performance reports and actionable insights, including quality metrics, care gap data, and population health dashboards (e.g., Garage platform). · Analyze provider performance from a clinical, operational, and financial perspective to identify opportunities for improvement. · Support access to EMRs, assist with medical record requests, and gather provider cooperation for performance initiatives. · Identify opportunities to expand or strengthen NSIPA’s provider network in alignment with strategic goals. · Assist with provider recruitment and engagement strategies in partnership with payers and internal stakeholders. · Develop an in-depth understanding of the unique needs and challenges of NSIPA’s provider network. · Support planning and execution of provider meetings, events, and educational seminars. · Work closely with internal teams across departments (e.g., Quality, Care Coordination, Contracting, IT) to ensure successful implementation of NSIPA initiatives. · Participate in Joint Operating Committee (JOC) meetings and collaborate with payers as needed. · Ensure timely resolution of provider issues, inquiries, or concerns, maintaining a high level of service and satisfaction. · Maintain accurate and up-to-date records of provider contacts, staffing, and key operational information. · Ensure the quality and completeness of documentation, including onboarding packets, orientation materials, and performance reports. · Assist with special projects and organizational initiatives, such as events, chart chases, EMR integration, or population health efforts. Skills & Competencies · Excellent interpersonal and communication skills, with the ability to build trust-based provider relationships. · Strong critical thinking and problem-solving abilities. · Self-motivated, organized, and able to manage competing priorities. · Proficiency in Microsoft Office Suite and other relevant software platforms. · A collaborative, entrepreneurial mindset aligned with NSIPA’s mission and provider-first philosophy. Core Attributes · Mission-driven and customer service-oriented · Strong sense of ownership and accountability · Analytical mindset with the ability to interpret data for actionable insights · Entrepreneurial spirit with a proactive approach to solving problems · High level of professionalism, integrity, and emotional intelligence Education & Experience · Bachelor’s degree in healthcare administration, public health, business, or a related field (master’s preferred). · 3+ years of experience in provider relations, network management, or a similar healthcare-facing role. · Knowledge of value-based care, managed care models, and healthcare provider operations. · Experience working with EMRs, performance reporting tools, and population health platforms is a plus.

Job DescriptionHealth Law PBM Associate Attorney or Special Counsel (Off-Track) Locations: Boston, New York, Washington, DC Direct Counsel is seeking a Health Law PBM Associate or Special Counsel to join a national Am Law 100–caliber firm with a premier Health Law Practice. This is an off-track (non-partnership) position and is ideal for attorneys with strong commercial contracting experience in the managed care and pharmaceutical supply chain/PBM space. About the Health Law Practice The Health Law Practice provides comprehensive guidance to a diverse array of clients, including providers, payors, PBMs, manufacturers, distributors, and other pharmaceutical supply chain participants. The team advises on complex litigation, transactions, operational issues, and regulatory matters, leveraging a cross-disciplinary approach to help clients navigate challenges and pursue business opportunities. Responsibilities The Associate or Special Counsel will support a national team advising health plans in their contracting relationships with pharmacy benefit managers (PBMs) and other pharmaceutical supply chain vendors. Core responsibilities include: * Drafting, reviewing, and negotiating PBM contracts and related commercial agreements (e.g., rebate agreements, pharmacy network contracts, vendor arrangements). * Leading and supporting the full contracting lifecycle for PBM procurements, including coordination with clients and in-person negotiations (occasional travel required). * Counseling clients on operational, regulatory, transactional, and contract administration matters affecting health plan operations. * Managing multiple contract workflows and collaborating with partners, clients, co-counsel, and opposing counsel. * Handling disputes arising under PBM and health plan contracts. This role requires the ability to work autonomously on day-to-day contract drafting and negotiations while maintaining close communication with team members. This position requires approximately 60% in-office presence in accordance with firm guidelines. Qualifications * JD or LLM from an ABA-accredited law school. * Admission to or eligibility for admission in MA, NY, or DC. * Minimum of 3+ years of transactional or commercial contracting experience in the managed care, PBM, or pharmaceutical supply chain industries. * Strong knowledge of federal and state regulations governing health plans, PBMs, and related entities preferred. * Excellent written and verbal communication skills. * Strong organizational skills and meticulous attention to detail. * Ability to manage competing priorities and work effectively in a team environment. * Experience with PBM operations, managed care contracting, or in-house PBM roles encouraged to apply. Compensation * Salary Range: $200,000 – $345,000 * Bonus-eligible * Comprehensive benefits package offered

Coding & Compliance, Credentialing, Managed Care Contracting) and external teams (e.

Senior Contract Manager Analyst. The Managed Care Contracting Team within MSHP is responsible for the negotiation, implementation and contract compliance related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. Senior Contract Manager Analyst.

Job DescriptionSenior Automated Litigation Support Lab Manager Employment Type: Full-Time, ExperiencedDepartment: eDiscovery As a CGS Senior ALS Lab Manager, you will leverage industry knowledge, and market research, and have wide-ranging experiences across operating systems and coding languages. You will serve as the lead manager responsible for the delivery of lab data processing services and be responsible for ensuring that incoming productions are made pursuant to the applicable ESI specifications and providing the case attorney with detailed notice of deficiencies. CGS brings motivated, highly skilled, and creative people together to solve the government’s most dynamic problems with cutting-edge technology. To carry out our mission, we are seeking candidates who are excited to contribute to government innovation, appreciate collaboration, and can anticipate the needs of others. Here at CGS, we offer an environment in which our employees feel supported, and we encourage professional growth through various learning opportunities. Skills and attributes for success:- Serves as the lead manager responsible for delivery of lab data processing services.- Primarily ensures timely and accurate completion of tasks. Performs analysis, development and implementation of processing approaches for electronic files and related services pursuant to applicable ESI specifications.- Consults with attorneys and support staff on best practices for conforming to ESI specifications and, as required, participates in teleconferences with co-counsel, client agencies, and opposing counsel upon attorney request.- Responsible for ensuring that incoming productions are made pursuant to the applicable ESI specifications and when deficiencies are found, provides case attorney with detailed notice of deficiencies.- Responsible for keeping the client informed on activities in the Lab, e.g. deadlines, technical challenges, and availability of resources to complete work. - Responsible for webhosting support for unsupported cases managed by the lab.- Manages a team of eDiscovery professionals situated in a client-site eDiscovery laboratory, including: scheduling, requirements assessments, assigning work and ensuring deadlines are met, creating progress reports, and Quality Control (QC) of deliverables.- Advises client attorneys, paralegals, and case managers on all phases of the Electronic Discovery Reference Model (EDRM); especially: Data Collection, Processing, Hosting, Review, Analytics, and Production. Qualifications:- Extensive Relativity experience required.- Relativity certifications including Relativity Certified Administrator (RCA) and/or Relativity Analytics Specialist strongly preferred.- At least eight years of experience performing eDiscovery roles including but not limited to electronic files processing (EFP), image and data file conversion, data culling using review tools, quality assurance, database loads and retrieval, and data analysis and review.- At least five years of experience at the management/supervisory level.- Requires thorough knowledge of the litigation discovery process, and the EDRM workflow.- Working knowledge and certifications of document review software such as iConect, Relativity, Venio or similar tools.- Undergraduate degree required, preferably in computer science or related field. Only the Contracting Officer can approve a waiver of the degree requirement. Ideally, you will also have:- Experience with litigation support tools such as LAW, IPRO, Concordance, MS Office Suite, and LiveNote highly valued. Our Commitment:Contact Government Services (CGS) strives to simplify and enhance government bureaucracy through the optimization of human, technical, and financial resources. We combine cutting-edge technology with world-class personnel to deliver customized solutions that fit our client’s specific needs. We are committed to solving the most challenging and dynamic problems. For the past seven years, we’ve been growing our government-contracting portfolio, and along the way, we’ve created valuable partnerships by demonstrating a commitment to honesty, professionalism, and quality work.Here at CGS we value honesty through hard work and self-awareness, professionalism in all we do, and to deliver the best quality to our consumers mending those relations for years to come. We care about our employees. Therefore, we offer a comprehensive benefits package.- Health, Dental, and Vision- Life Insurance- 401k- Flexible Spending Account (Health, Dependent Care, and Commuter)- Paid Time Off and Observance of State/Federal Holidays Contact Government Services, LLC is an Equal Opportunity Employer. Applicants will be considered without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Join our team and become part of government innovation!Explore additional job opportunities with CGS on our Job Board: more information about CGS please visit: or contact:Email: #CJ We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

Job Description Fractional-CEO for Startup. Founding team is in NYC. Their preference is onsite in Long Island, NY. However, they're open to remote candidates with the right experience. Our client is a PE-backed platform prepared to build nation-wide Home & Community-Based Services (HCBS). They are looking for a Chief Growth Officer that's ambitious and prepared to build a company that'll scale into all 50 states through a mix of organic de-novo launches and rapid M&A. If you've taken HCBS or home-health entities from application to first claim in multiple states, this is your green-field moment. I need 10+ years building or flipping HCBS/HHA entities in 2 or more states. Location • Preferred: On-site with the founding team on Long Island, NY (easy commute from NYC)., • Operational Launch & Scale, • Own every state filing, readiness checklist, survey, and first-claim timeline., • Stand up EVV, scheduling, payroll, and claims across de-novo and acquired agencies., • Regulatory & Clinical Compliance, • Serve as Chief Growth Officer for all state, CMS, and managed-care requirements., • Lead QAPI, incident-management, and continuous-survey preparedness., • M&A Execution, • Partner with PE sponsors on diligence; translate LOIs into operational day-1 plans., • Integrate people, processes, and tech while safeguarding clinical quality., • Payer & Referral Contracting, • Negotiate/network with Medicaid MCOs, Medicare Advantage, PACE, VA Community Care, AAAs, and health-system discharge planners., • People & Culture, • 10+ years building or turning around HCBS/Home-Health agencies in two or more states., • End-to-end experience taking at least two entities from initial application to first paid claim (licensure, waiver enrollment, MCO credentialing, EVV go-live)., • Demonstrated success scaling through both de-novo launches and M&A integration., • Deep working knowledge of §1915(c)/(k) waivers, CMS-855A, ACHC/CHAP/JCAHO standards, HIPAA, EVV, incident reporting, and QAPI., • Track record negotiating multi-state MCO/MA contracts and aligning them with operating economics., • Built or led a national platform backed by private equity., • Builder's Mindset: You see blank maps as playgrounds., • Compliance-First: Quality and safety are non-negotiable., • People-Centric: You scale humans, not just dashboards., • Green-Field Authority: Architect the playbook that wins all 50 states., • PE Firepower: Capital is committed for aggressive de-novo growth and rapid M&A., • National Impact: Keep vulnerable populations healthy at home—at scale., • Career Defining: Be the operations & compliance force behind a future market leader.

A company is looking for a Head of Networking Contracting. Key Responsibilities Develop and execute national payer contracting strategy focused on value-based and full-risk arrangements Lead national payer relationships, including negotiation and performance oversight with health plans Oversee c