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Life, Health & Pension Positions

The following is a partial listing of the exciting Life, Health & Pension opportunities available through Martin Grant Associates, Inc. 


PHARMACIST


$95 - 105K


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8-146


Responsible for managing the day-to-day relationship with the specialty pharmacy vendor.  Handle issues/concerns with the vendor, track outstanding issues to ensure appropriate resolution and work with senior director of pharmacy to monitor/audit vendor performance.  Participate in day-to-day operations of the pharmacy department and assist with clinical pharmacy services.  Review prior authorization requests according to the company’s medication request guidelines, pharmacy prior authorization policy and procedures and NCQA and contractual requirements.  Responsible for monitoring of specialty prior authorizations according to pharmacy prior authorization policy and procedures.  Oversee specialty pharmaceuticals utilization and review within clinical affairs.  Coordinate services between pharmacy and medical management.  Monitor crossover utilization between pharmacy and medical claims.  Work with pharmacy team and the company’s network management and contracting teams to give the company a best cost position (when possible) for specialty pharmaceuticals.  Person must have experience in researching drugs from both a business and clinical perspective and are able to present his/her recommendations.  Location:  Greater Boston.  Please contact Juliet K. Clark, CPC at 617-423-0052.  You can fax your resume to 617-482-6581 or email me at martingrant@msn.com.  


AVP PRODUCT DEVELOPMENT - NY


$150 - 175K + BONUS


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8-149


Lead consultative team of subject matter "experts" to drive experienced producer business growth through:  business planning and execution, coordination of resources and business partners, relationship building, support of practice infrastructure development, partnering/team selling, personal development programs and venues, practice transition support and packaging and branding.  Develop, maintain and support relationships with field management; working consultatively as subject matter "expert" for experienced producers.  Develop and manage relationships with internal business partners to coordinate resources and drive growth.  Identify and drive practice enhancement processes based on identified gaps and needs.  Support the structuring of specific producer career paths and the associated development opportunities for representatives.  Partner with internal FDG IXP/EXP recruiting teams to help enhance the company’s value proposition.  Work with key partners, develop communication strategy around programs for both internal and external partners.  Work with internal FDG partners to develop analytics and reporting structures to measure impact of programs on the business.  Location:  Long Island, NY.  Please contact Juliet K. Clark, CPC at 617-423-0052.  You can fax your resume to 617-482-6581 or email me at martingrant@msn.com


MANAGER, COMPLIANCE


$80 - 86K


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8-130


Under the general direction of the Chief Compliance Officer, responsible for the development and implementation of the company’s Billing and Coding Compliance Plan.  Monitor billing and coding compliance activities conducted by the company’s departments including Health Information Management, Hospital Billing, Care Management, Physician Organization billing and coding and others as needed.  Conduct coding and billing audits as required by the company’s Billing and Coding Compliance Plan.  Collaborate with other departments to develop and disseminate current information on correct billing, coding and documentation practices, to develop policies and to improve billing and coding systems and procedures.  Assist the Chief Compliance Officer in the development and implementation of the annual company’s Compliance Plan for all compliance program elements.   Maintain a current knowledge of regulations, compliance issues and compliance program best practices.  Registered Nurse, Registered Health Information Administrator or Registered Health Information Technologist strongly preferred.  Location:  Metro Boston.  Please contact Juliet K. Clark, CPC at 617-423-0052.  You can fax your resume to 617-482-6581 or email me at martingrant@msn.com.


CONTRACT MANAGER-COMMERCIAL


$80 - 115K


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8-126


The position of Contract Manager - Commercial, in the Network Contracting and Performance Management department, serves as the primary point of contact with providers to negotiate contracts with network physicians and hospitals.  This individual is the primary lead during negotiations and is accountable for the financial and legal terms negotiated with the providers.  In addition, will ensure that contract terms are consistent with the corporate contracting strategy and are negotiated within the established legal and financial guidelines as established by the company.  Will ensure that any non-standard elements of any contract negotiation has been properly researched and communicated to key internal stakeholders and with the appropriate personnel from the Contract Management and Implementation area, successfully implemented within the company’s system and processes.  Location:  Metro Boston.  Please contact Juliet K. Clark, CPC at 617-423-0052.  You can fax your resume to 617-482-6581 or email me at martingrant@msn.com.


CONSULTANT - COST ALLOCATION


$60 - 90K


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8-124


Lead efforts to write and prepare cost allocation plans on behalf of the company’s clients.  Lead efforts to prepare and negotiate indirect cost rates.  Support and assist with proposal development related to cost allocation plans, indirect cost rates and related projects.  Assist with conducting training seminars on related topics and securing new business in this area.  Collaborate on other projects as necessary.   Be familiar with Office of Management and Budget (OMB) Circular A-87, Medicare and Medicaid Cost Principles and/or cost allocation methodologies used by government agencies and/or health facilities.  Knowledge of the Federal Medicaid program and other health and human services programs, including Food Stamps, Title IV-E, Title IV-B, and Temporary Assistance to Needy Families (TANF).   Ability to manage multiple staff and clients.  Location:  Boston.  Please contact Juliet K. Clark, CPC at 617-423-0052.  You can fax your resume to 617-482-6581 or email me at martingrant@msn.com


ACCOUNT REPRESENTATIVE - NH


$40 - 50K


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8-118


Responsible for new and renewal business quoting, formal RFP submission, proposal generation, rate and benefit contract negotiations, open enrollment support, carrier notification, new business installation, post-open enrollment service on carrier transaction issues and internal record updating.  Ongoing client service and assistance with all cases, claims research and resolution, carrier billing and invoice assurance, ancillary claims coordination, enrollment support, file documentation and issue resolution.  Maybe required to travel as needed. No more than 10-15% throughout the year to attend client, carrier and corporate events.  Please contact Juliet K. Clark, CPC at 617-423-0052.  You can fax your resume to 617-482-6581 or email me at martingrant@msn.com.


DIRECTOR COMMERCIAL CONTRACTING


$140 - 150K +BONUS


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8-115


Responsible for negotiating contracts for commercial hospitals, physician groups and integrated delivery systems.  Will participate in the development of new contracting reimbursement models and will lead the negotiation of these models with providers.  Will be responsible for achieving a targeted unit cost trend in support of the company's overall medical cost trend targets.  Also be charged with negotiating operational and contractual terms in support of the company's objectives and maintain the organization's collaborative working relationship with providers.  Direct a team of contract managers, some of whom have direct reports and  interface closely with two other Directors in Provider Contracting, the Director of Contracting Strategy and Analytics as well as the Director of Provider Management.  Location:  Metro Boston.  Please contact Juliet K. Clark, CPC at 617-423-0052.  You can fax your resume to 617-482-6581 or email me at martingrant@msn.com.


BUSINESS PROJECT PROGRAM MANAGER


$74 - 97K


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8-106


Manage and be accountable for ensuring student health products and services meet regulatory requirements and maintain compliance with benefit and system requirements.  Serve as a liaison between student health and corporate compliance resources to ensure organizational compliance goals are met and activities are managed effectively.  Oversee a team of benefit consultants whose focus includes:  Review of request for proposals for new and renewing cases to determine product adherence and identify gaps with regulatory and operational requirements, review of member marketing materials (brochures, certificates of coverage, enrollment applications, websites, master policies) for accuracy and compliance with regulatory and operational requirements, participate in process to implement new laws and regulations into the student health business and support process for developing single-case and broader regulatory filing needs.   Location: Metro Boston.  Please contact Juliet K. Clark, CPC at 617-423-0052.  You can fax your resume to 617-482-6581 or email me at martingrant@msn.com.


FIELD BENEFITS ACCOUNT SERVICE REP


$52 - 57K


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8-85


Maintain frequent contact with trust members statewide by mail, phone, field visits and presentations.  Maintain member satisfaction of existing accounts through personal contact with appropriate municipal officials, boards and/or committees.  Conduct consultative, educational and informational sessions with account to promote programs.  Participate in development and presentation of strategies for account renewal and retention.  Serve as liaison between insured municipality, third party administrators/service providers and the staff.  Provide guidance and assistance to the membership in the management of administrative issues and problems.  Monitor performance of third party administrators/service providers and notify management of administrative issues and problems as needed.   Act as account ombudsman.  Must have on the road experience meeting with accounts.  Location: Boston.  Please contact Juliet K. Clark, CPC at 617-423-0052.  You can fax your resume to 617-482-6581 or email me at martingrant@msn.com.


SR. ACCOUNT EXECUTIVE - LARGE GROUP -RI


$65 - 75K + COMMISSION


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8-74


Will sell through brokers and cases are primarily 50-500 lives.  Mostly handle New England but can sell anywhere.   Location:  Providence, RI. Please contact Juliet K. Clark, CPC at 617-423-0052.  You can fax your resume to 617-482-6581 or email me at martingrant@msn.com.


PRODUCER


$50K + COMMISSION


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8-67


Will sell through brokers and cases are primarily 50-500 lives.  Mostly handle New England but can sell anywhere.   Location:  South of Boston. Please contact Juliet K. Clark, CPC at 617-423-0052.  You can fax your resume to 617-482-6581 or email me at martingrant@msn.com.


RISK MANAGER - ME


$65 - 86K


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8-58


Responsible for managing the risk management departmental operations including claims management, interfacing with defense legal counsel, administration of a progressive risk management program on a daily basis, analysis risk management data, conducting educational programs, compliance with accreditation standards and regulatory authorities and enhancement of the quality of care to improve patient safety.  Location:  Portland, ME.  Please contact Juliet K. Clark, CPC at 617-423-0052.  You can fax your resume to 617-482-6581 or email me at martingrant@msn.com.



MARTIN GRANT ASSOCIATES, INC.
65 FRANKLIN STREET
BOSTON, MA 02110
TEL. (617)357-5380
FAX (617)482-6581
martingrant@msn.com


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