Integreon Managed Solutions Address Jobs in Usa
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Title: Managed Care Contract Analyst
Duration: Full-Time
Location: Dalton, GA - Remote or Hybrid
Working Schedule: 8:30 AM - 5:00 PM
Position Overview
The Managed Care Contract Analyst is responsible for the day-to-day management, modeling, and performance analysis of payer contracts. This role partners closely with the Director of Managed Care Contracting to support contract negotiations, reimbursement modeling, and ongoing payer performance monitoring. The analyst will interpret complex contract language, identify reimbursement trends and issues, and support revenue cycle optimization initiatives.
Key Responsibilities
- Manage and maintain payer contracts, including inventory of agreements, rate grids, and contract terms.
- Support contract negotiations through data extraction, analysis, and complex reimbursement modeling.
- Model and assess payer reimbursement performance and identify trends in payment practices.
- Identify and assist with revenue cycle reimbursement issues and communicate findings to stakeholders.
- Interpret complex administrative and financial contract language and clearly communicate impacts internally and externally.
- Stay current on payer billing and reimbursement changes and proactively communicate updates.
- Interface with outside vendors and consultants as needed.
- Complete credentialing and re-credentialing applications.
- Ensure accuracy and integrity of contract management systems and data.
Education
- Bachelor’s degree in Business, Accounting, Finance, or Healthcare Management
Experience
- 3–5+ years of healthcare managed care or payer contract management experience.
- Strong understanding of payer contract language and reimbursement methodologies.
- Hands-on experience with:
- CPT, ICD-9, and modifiers
- Hospital Medicare and Medicaid fee schedules
- Third-party billing requirements and claim payment methodologies
- Claim system requirements, procedures, and controls
Skills
- Advanced proficiency in Excel; working knowledge of Word and PowerPoint.
- Strong analytical skills with high attention to detail.
- Excellent written and verbal communication skills.
- Experience with contract management software or strong technical aptitude to learn quickly.
Job Title: Radiology Nurse Manager (Permanent)
Location: White Plains, New York
Salary: $143,376 – $190,955 per year
Schedule: 4 x 10-hour Day Shifts
Seven Healthcare is currently seeking an experienced Radiology Nurse Manager for a permanent leadership opportunity in White Plains, NY. This is an excellent opportunity for a skilled Registered Nurse (RN) with leadership experience to oversee radiology nursing services, manage staff performance, and ensure the highest standards of patient care within a fast-paced hospital environment.
This role offers a highly competitive annual salary, leadership responsibilities, and the opportunity to contribute to operational excellence within a respected healthcare organization.
Key Responsibilities
Strategic Leadership
- Align departmental goals with the hospital’s nursing and organizational strategic plans.
- Lead service development initiatives and implement evidence-based nursing practices.
- Collaborate with interdisciplinary teams to improve patient outcomes and service delivery.
- Promote innovation, shared governance, and continuous improvement within the radiology department.
- Support disaster preparedness and emergency response planning.
Human Resources Management
- Ensure compliance with nursing performance standards, hospital policies, and professional behaviors.
- Manage staffing levels based on department budget, patient acuity, and census.
- Lead recruitment, interviewing, hiring, onboarding, and orientation of nursing staff.
- Provide coaching, mentorship, and performance evaluations for nurses and support staff.
- Support staff development, competency validation, and succession planning.
- Foster staff engagement, retention, and recognition programs.
- Facilitate team communication through meetings, rounding, and departmental briefings.
- Manage disciplinary procedures and corrective action when necessary.
Financial Management
- Oversee departmental operational and capital budgets.
- Monitor productivity metrics and full-time equivalent (FTE) staffing levels.
- Evaluate reimbursement impacts and improve care efficiency.
- Forecast revenue and departmental expenditures.
Performance and Quality Management
- Develop and maintain evidence-based policies, procedures, and clinical standards.
- Lead quality improvement initiatives and monitor departmental KPIs.
- Improve patient satisfaction and service excellence initiatives.
- Promote patient safety through incident reporting and root cause analysis participation.
- Maintain readiness for regulatory inspections and accreditation reviews.
- Ensure compliance with the New York State Nurse Practice Act and professional ethical standards.
Relationship Management
- Foster collaboration and teamwork across departments.
- Resolve conflicts and support a positive workplace culture.
- Act as a professional role model and change leader within the department.
- Respond effectively to urgent clinical and operational situations.
Technology and Systems
- Utilize healthcare information systems to support clinical operations and performance tracking.
- Evaluate new technologies that enhance patient care and departmental efficiency.
Professional Development
- Maintain clinical and leadership knowledge through continuing education.
- Participate in professional organizations and leadership initiatives.
- Complete additional duties as required to support departmental success.
Requirements
- Active Registered Nurse (RN) license in New York or eligibility to obtain prior to start
- Bachelor of Science in Nursing (BSN) required
- BLS and ACLS certifications required
- Previous nurse leadership or management experience, ideally within radiology or procedural services
- Strong clinical assessment and critical thinking skills
- Experience managing high-acuity patients in a fast-paced healthcare environment
- Excellent leadership, communication, and teamwork abilities
Why Work in White Plains, New York?
White Plains offers an excellent balance of city accessibility and suburban quality of life, making it an ideal location for healthcare professionals.
Why Work with Seven Healthcare?
Seven Healthcare is a nationally recognized healthcare recruitment agency known for competitive salaries, career advancement opportunities, and dedicated recruiter support. With 5-star Google reviews, recognition as Best Healthcare Staffing Company 2024 by BluePipes, and top ratings on Vivian, we are trusted by healthcare professionals nationwide.
About the Opportunity
This is an opportunity for a Managing Director, Operations to join a top team at Brown Harris Stevens. The ideal candidate is a senior leader who will run the day-to-day business so the founder and sales team can
focus on sales and originating relationships and driving revenue. This is a high-impact leadership role for a seasoned real estate professional who thrives on building teams, running complex operations, and translating sales activity into consistent, scalable performance. You will serve as the operational leader of the business, owning execution across team management, sales operations, financial performance, and implementation of processes. You will work in close
partnership with the team leader, acting as her operational counterpart and ensuring the business
runs with discipline, clarity, and momentum. This role is ideal for someone who enjoys leading people, driving accountability, and building systems that scale a top-producing residential real estate team.
What You’ll Own:
Business & Team Operations
● Lead the day-to-day operations of the business, team, and staff
● Directly manage and develop team members, including recruiting, onboarding, training, performance management, and motivation
● Ensure the team has the tools, clarity, and resources needed to perform at a high level
● Foster a culture of accountability, professionalism, and continuous improvement
Sales Operations & Pipeline Management
● Own the sales pipeline end-to-end, maintaining visibility into every opportunity and its lifecycle
● Track deadlines, follow-ups, and next actions to ensure consistent execution
● Design and implement processes to grow and convert pipeline (referrals, open houses, inbound leads, repeat clients)
● Ensure listing, contract, and closing processes are documented, efficient, and error-free
Financial Management & Performance Tracking
● Own KPIs, forecasting, budgeting, and performance reporting
● Monitor revenue, expenses, and productivity against team and individual goals
● Prepare regular reports and insights for the founder to support decision-making
● Partner with team leader to set annual goals and manage toward them
Process, Systems & Compliance
● Own operational process design across listings, transactions, and closings
● Ensure contracts, documentation, and compliance requirements are met consistently
● Oversee CRM, contact management, and marketing workflows to ensure data integrity and follow-through
● Collaborate closely with marketing, sales, and administrative support to maintain operational excellence
Strategic Partnership
● Act as a thought partner on strategy, execution, and team development
● Translate vision and goals into actionable plans and priorities
● Provide continuous feedback on performance, risks, and opportunities
Requirements
● 3–5+ years of residential real estate experience, ideally in a high-producing team environment
● 5+ years of operations or business management experience, with direct people leadership
● New York State Real Estate License (required within 6 months of joining)
● Strong technical fluency, including:
○ Excel / Google Sheets
○ CRM systems
○ Marketing and workflow automation tools
○ Comfort using modern AI tools to improve productivity
Key Attributes for Success
● Trusted leader: High integrity, sound judgment, and consistency in execution
● Operationally sharp: Detail-oriented while able to see the big picture
● Metrics-driven: Uses data to guide decisions and drive accountability
● Excellent communicator: Clear, direct, and effective with all stakeholders
● Calm under pressure: Handles fast-moving environments with professionalism and composure
● Self-directed: Takes ownership, anticipates needs, and drives outcomes without hand-holding
Work Environment
● 100% in-office role at our Manhattan executive office
● Flexibility to work remotely when business needs arise
Benefits
● Competitive base salary ($110,000 - $125,000) + performance bonus tied to business growth
● Employer-subsidized healthcare
● 401(k)
● Pre-tax commuter benefits
● PTO including:
○ 6 paid holidays, 15 days paid vacation, 7 days paid sick leave
Assists Community First Health Plan (CFHP) members regain optimum health or improved functional capacity by ensuring that members have access to all of the health care services they need in the most efficient and effective manner possible. Responsibilities include but are not limited to overseeing the allocation of resources, cost and quality of health care for members; coordinating care between the primary care physician, community resources, family and member; coordinating care across the health care continuum while monitoring and managing benefit utilization; and, collaborating with multi-disciplinary health care team members in identifying the educational and discharge needs of members.
EDUCATION/EXPERIENCE
Registered Nurse (RN) is required. Bachelor of Science in Nursing (BSN) or Master’s degree is preferred. Minimum three (3) years nursing, acute care, quality management or managed care experience is required. Basic knowledge of Medicaid, Medicare, community resources and alternate funding programs is desired. Knowledge of InterQual screening criteria as well as DRG, ICD and CPT coding is preferred.
LICENSURE/CERTIFICATION
Current licensure as a Registered Nurse with the Texas State Board of Nurse Examiners is required. Current certification from an appropriate professional agency, such as Case Management Society, is preferred.
Location: Columbia, SC 29229
Work Environment: Remote (after 1 week of Onsite training)
Schedule: Mon - Fri, 8:30 AM - 5:00 PM (Two late shifts, 11:30 am - 8:00 pm - no late shifts on Fridays)
Contract length: 3 months assignment with possible extension
Job Summary:
Duties/About the role:
Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical expertise, administrative policies, and established clinical criteria to service requests or provides health management program interventions. Utilizes clinical proficiency, claims knowledge/analysis, and comprehensive knowledge of healthcare continuum to assess, plan, implement, coordinate, monitor, and evaluate medical necessity, options, and services required to support members in managing their health, chronic illness, or acute illness. Utilizes available resources to promote quality, cost effective outcomes.
Day to Day:
- 60% Provides active case management, assesses service needs, develops and coordinates action plans in cooperation with members, monitors services and implements plans, to include member goals. Evaluates outcomes of plans, eligibility, level of benefits, place of service, length of stay, and medical necessity regarding requested services and benefit exceptions. Ensures accurate documentation of clinical information to support and determine medical necessity criteria and contract benefits. Provides telephonic support for members with chronic conditions, high risk pregnancy or other at risk conditions thatconsist of: intensive assessment/evaluation of condition, at risk education based on members' identified needs, provides member-centered coaching utilizing motivational interviewing techniques in combination with reflective listening and readiness to change assessment to elicit behavior change and increase member program engagement.
- 20% Performs medical or behavioral review/authorization process. Ensures coverage for appropriate services within benefit and medical necessity guidelines. Utilizes allocated resources to back up review determinations. Identifies and makes referrals to appropriate staff (Medical Director, Case Manager, Preventive Services, Subrogation, Quality of care Referrals, etc.). Participates in data collection/input into system for clinical information flow and proper claims adjudication. Demonstrates compliance with all applicable legislation and guidelines for all regulatory bodies, which may include but isnot limited to ERISA, NCQA, URAC, DOI (State), and DOL (Federal).
- 10% Participates in direct intervention/patient education with members and providers regarding health care delivery system, utilization on networks and benefit plans. May identify, initiate, and participate in on-site reviews. Serves as member advocate through continued communication and education. Promotes enrollment in care management programs and/or health and disease management programs.
- 5% Maintains current knowledge of contracts and network status of all service providers and applies appropriately. Assists with claims information, discussion, and/or resolution and refers to appropriate internal support areas to ensure proper processing of authorized or unauthorized services.
- 5% Provides appropriate communications (written, telephone) regarding requested services to both health care providers and members.
Job Requirements:
Required Education:?
Associate Degree - Nursing or Graduate of Accredited School of Nursing or Master's degree in Social Work, Psychology, or Counseling.
Required Work Experience: 4 years recent clinical in defined specialty area. Specialty areas include: oncology, cardiology, neonatology, maternity, rehabilitation services, mental health/chemical dependency, orthopedic, general medicine/surgery. Or, 4 years utilization review/case management/clinical/or combination; 2 of the 4 years must be clinical.
Required License and Certificate: Active, unrestricted RN licensure from the United States and in the state of hire, OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC), OR, active, unrestricted LMSW (Licensed Master of Social Work) licensure from the United States and in the state of hire, OR active, unrestricted licensure as Counselor, or Psychologist from the United States and in the state of hire.
Preferred Education: Bachelor's degree- Nursing.
Preferred Work Experience: 7 years-healthcare program management, utilization review, or clinical experience in defined specialty. Specialty areas are oncology, cardiology, neonatology, maternity, rehabilitation services, mental health/chemical dependency, orthopedic, general medicine/surgery.
If you're ready for the next level, we have a Managing Dentist position in which you are responsible for the office operations and performance along with the office business manager. The Managing Dentist performs most of the new patient exams, mentors new dentists, and coordinates care for patients with the Specialists.
Here's a few reasons why dentists love to work with us:
- Doctors have autonomy in creating treatment plans while providing direct care to their patients
- We are an established organization with an expert Clinical & operations leadership team focused on giving our patients the best experience
- Offices receive corporate support from departments including: Billing, Marketing, Call Center, Procurement, IT, Facilities, Human Resources, Legal, and more!
Benefits for FT Providers
- Office profitability incentive program
- Healthcare Benefits (Medical, Dental, Vision)
- Continuing Education
- 401(k)
- Employee Assistance Program
Responsibilities
- Conduct comprehensive oral examinations and evaluations to diagnose dental problems
- Develop and implement personalized treatment plans for patients
- Perform a wide range of procedures, including fillings, cleanings, extractions, and root canals
- Educate patients on proper oral hygiene practices and post-treatment care
- Maintain accurate and confidential patient records, including X-rays and treatment histories
- Refer patients to specialists (like orthodontists or oral surgeons) for complex treatments
- Mentor and build good rapport with office staff
- Partner with operational leadership to achieve production goals, uphold clinical excellence, and continuously improve workflows
- Ensure all work is compliant with safety, OSHA, and infection control standards
Qualifications
- DMD or DDS from accredited dental school
- Active, unrestricted state dental license or in the process of obtaining a license upon graduation
- 3+ years experience as a practicing dentist
- CPR/BLS certification
- DEA certification
- NPI number
Western Dental Services, Inc. and all relevant affiliates are Equal Opportunity Employers.
Identifies Community First Health Plan members with specific health care needs and provides case management interventions. Analyzes, approves health care services and monitors outpatient care planning for Community First Health Plans members based on established criteria, plan policies and procedures. Formulates and communicates case management plans that efficiently utilize health care services to move the member along the continuum of care towards optimum outcomes in the safest, most cost effective manner.
EDUCATION/EXPERIENCE
Graduation from an accredited school of professional nursing is required, BSN preferred. Master’s degree is preferred. Minimum three years’ acute care experience or managed care experience is required. Minimum one-year of concurrent review experience is required. Candidate must have utilization management and/or quality assurance experience. Basic knowledge of Medicaid, community resources and alternate funding programs is desired. Knowledge of InterQual screening criteria as well as DRG, ICD-9 and CPT coding is preferred.
LICENSURE/CERTIFICATION
Current Registered Nurse license to practice professional nursing issued by the Board of Nurse Examiners for the State of Texas is required. Active Certification in Case Management (CCM) designation is preferred.
Job Description True Work/Life balance with expanding managed care group Join a thriving dedicated care team in Palmetto, Florida Outpatient-only setting See only 15 patients per day Monday
- Friday 8:00am
- 5:00pm No Nights
- No Weekends Call is 100% options and for additional income Group has ancillary services including labs/pharmacy Amazing and supportive culture Compensation and Benefits Competitive and negotiable salary based on experience Quarterly bonuses on top of base salary Malpractice and Tail Coverage 4 weeks PTO plus paid holidays Health insurance Life and disability insurance CME-DEA and license all paid for 401k and retirement Community Great location just north of Bradenton Tucked in between the Manatee River and Terra Ceia Bay Stunning natural settings You are always just minutes from waves and water views
Job Description True Work/Life balance with expanding managed care group Join a thriving dedicated care team in Palmetto, Florida Outpatient-only setting See only 15 patients per day Monday
- Friday 8:00am
- 5:00pm No Nights
- No Weekends Call is 100% options and for additional income Group has ancillary services including labs/pharmacy Amazing and supportive culture Compensation and Benefits Competitive and negotiable salary based on experience Quarterly bonuses on top of base salary Malpractice and Tail Coverage 4 weeks PTO plus paid holidays Health insurance Life and disability insurance CME-DEA and license all paid for 401k and retirement Community Great location just north of Bradenton Tucked in between the Manatee River and Terra Ceia Bay Stunning natural settings You are always just minutes from waves and water views
Lead with Purpose. Care with Heart.
Are you a licensed pharmacist with a passion for patient care and team development? Hometown Pharmacy is looking for a Pharmacy Manager to lead and inspire our pharmacy team while ensuring exceptional service, clinical excellence, and operational efficiency.
If you're a hands-on leader who thrives in a fast-paced environment, values proactive healthcare, and enjoys helping both patients and staff succeed—this is your opportunity to make a meaningful impact. We go beyond filling prescriptions, embracing functional medicine, wellness, and patient education to redefine the pharmacy experience.
A Schedule You’ll Love:
Tired of late nights and unpredictable hours? At Hometown Pharmacy, we believe in work-life balance. All locations close by 6 PM on weekdays, 1 PM on Saturdays, and are completely closed on Sundays. Yes — every Sunday off, guaranteed!
The Role:
As a Pharmacy Manager, you’ll lead daily operations, mentor your team, and drive excellence in patient care and customer service. You’ll also play a key role in advancing our clinical and wellness programs, including MTM, CBD, nutraceuticals, and functional health initiatives.
Key Responsibilities:
- Manage pharmacy operations, staffing, workflow, and compliance.
- Lead, mentor, and evaluate pharmacy team members through coaching and performance reviews.
- Collaborate with store leadership to ensure a smooth, unified customer experience.
- Implement MTM programs, clinical services, and wellness initiatives.
- Provide ongoing staff training in wellness, functional health, and pharmaceutical care.
- Resolve escalated patient concerns with empathy and professionalism.
- Cultivate strong patient relationships and foster an education-first environment.
- Ensure adherence to safety protocols, best practices, and regulatory compliance.
Qualifications:
- BS or PharmD in Pharmacy
- Active Wisconsin Pharmacist License
- Minimum 3–5 years of pharmacy experience, including supervisory or leadership roles
- Immunization and CPR certification (required)
- Strong communication, leadership, and process improvement skills
- Passion for wellness and functional medicine
- Entrepreneurial mindset or interest in ownership opportunities (optional)
Why Join Hometown:
We offer more than a job — we offer a place to grow, lead, and make a difference in your community.
Benefits:
- Supportive team culture and strong leadership guidance
- Bi-annual continuing education in pharmacy, wellness, and business
- Access to nutraceutical, and functional health training programs
- Health & Dental Insurance, 401(k) with company match, Flexible Spending Account (FSA)
- 25% employee store discount
- Generous PTO: 3 weeks vacation, 6 paid holidays, 2 personal days, up to 112 hours sick time
- Consistent schedule with evenings off and Sundays guaranteed off
Ready to Join Our Hometown?
Take your pharmacy career to the next level, make a meaningful impact, and lead a team that’s redefining patient care. Apply today!
