- iCare Health Solutions Enterprise (Miami, FL)
- …Contract Utility, supporting both traditional fee-for-service (FFS) reimbursement and managed care models, including capitated, global payment, and ... to ensure seamless implementation of negotiated agreements Act as the liaison between Managed Care , Revenue Cycle, IT, and Clinical Operations for contract… more
- Daiichi Sankyo, Inc. (Bernards, NJ)
- … Contract Forecasting to ensure support of cross-functional teams regarding key managed care accounts and ASP analysis. This includes: profitability analysis ... ability to develop that knowledge; preferredDetailed knowledge of all channels of managed care environment in the US (commercial, Medicare, Medicaid, etc.);… more
- CSI Pharmacy (Nash, TX)
- …information Manages the tracking, approval, administration, and post-implementation process of all managed care contracts throughout contract life cycle ... structure for both payors and providers Responsible for all aspects of managed care and direct revenue contract management including analysis interpretation,… more
- Emanate Health (Covina, CA)
- …preferred. Experience within an acute hospital setting, with strong emphasis on managed care contract and appeals/underpayment collection activities. ... at Emanate Health plays a vital role in the care we deliver. No matter what department you belong...Knowledge of networks, IPA's, HMO's, PPO's and PCP's and contract affiliations. Strong analytical skills, proficient with spreadsheets. c.… more
- Sherman Oaks Hospital (Sherman Oaks, CA)
- …of contract interpretation 4. Familiar with hospital billing requirements 5. Understanding of managed care payor contract and contract language 6. ... Overview Sherman Oaks Hospital is a 153-bed, not-for-profit, acute- care community hospital located in Sherman Oaks, California....the hospital is recognized for advanced technology and compassionate care and provides 24/7 emergency care in… more
- University of Southern California (Los Angeles, CA)
- …and documents avoidable delays in the M drive. *Maintains awareness of current managed care contract requirements. *Participates in appeal process. *Performs ... In collaboration with the interdisciplinary team, provides care coordination services evaluating options and services required to meet an individual's health care… more
- CommuniCare Family of Companies (Cincinnati, OH)
- CommuniCare Health Services is currently recruiting a Corporate Accounts Receivable / Managed Care Support Specialist. PURPOSE / BELIEF STATEMENT The A/R ... Managed Care Support Specialist will assist in...receivables escalation and resolution, denials management, payment variance, and contract modeling. Responsibilities also include tracking/trending performance metrics for… more
- Alignment Healthcare (San Diego, CA)
- …methodologies, contract language, negotiation strategies, financial modeling and analysis, managed care and Medicare Advantage plans; or any combination of ... care finance and contracts Strong knowledge of Medicare managed care and associated contract language Excellent interpersonal and relationship… more
- Teva Pharmaceuticals (Parsippany, NJ)
- …and new people to make a difference with. The opportunity The Associate Director, Managed Care Payer Analytics is responsible for leading the analytical strategy ... that supports the financial evaluation, contract development and performance monitoring across commercial and government payer channels for assigned National… more
- PIH Health (Whittier, CA)
- …for training employees to perform accurate and timely follow up of Commercial and Senior Managed care claims and all payer mix through resolution. Serves as a ... resource on PM computer systems and Contract specific regulations. Assists with follow up, assists with...credit balances, and correspondence from various Medi-Cal and or Managed Care HMO Plans. Review of Medi-Cal… more
- St. Luke's University Health Network (Allentown, PA)
- …and ensuring active governance across the vendor pool Deliver a structured managed contract process from determining needs, assisting in vendor selection, ... which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses...are not limited to organizing and directing vendor evaluations, contract engagement, and value analysis for IT, RFI/RFPs as… more
- Vertex Pharmaceuticals (Boston, MA)
- …discuss and incorporate contracting strategies and tactics, and understand the various types of managed care contracting. This is a highly visible role that will ... Job Description Reporting to the Director, Contract Operations, this role is responsible for the...including but not limited to specialty pharmacy, provider and managed care payors is required (health plans,… more
- MCI Careers (Wichita, KS)
- …applicant on the basis of age, ancestry, color, family or medical care leave, gender identity or expression, genetic information, marital status, medical condition, ... Provider (DXP), Account Receivables Management (ARM), Application Software Development, Managed Services, and Technology Services, to mid-market, Federal &… more
- UPMC Senior Communities (Pittsburgh, PA)
- …complex situations accurately and in a timely manner. General knowledge of managed care functions and management techniques preferred. Licensure, Certifications, ... UPMC Community Care Behavioral Health is hiring a full-time Contract Specialist II. This role will predominantly work remotely but may require occasional… more
- McKesson Corporation (Irving, TX)
- …customers on solutions - including supply management technology, world-class marketing programs, managed care and repackaging products and services - that help ... for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on...tomorrow's health today, we want to hear from you. Contract Admin Senior Contract Specialist (P3) Job… more
- Compass Group (Fort Washington, PA)
- …include inventory, ordering and receiving + Knowledge of P&L accountability and contract - managed service experience is desirable + Proficient in menu ... Everything we do means more when it's served with care . The exceptional care and culinary artistry...exposition cooking needed + Knowledge of P&L accountability and contract - managed service experience is desirable + ServSafe… more
- Optum (San Juan, PR)
- …of Medicaid/Medicare Reimbursement methodologies Working knowledge of the healthcare insurance/ managed care industry Working knowledge of medical terminology ... Optum is a global organization that delivers care , aided by technology to help millions of...to state and federal compliance policies, reimbursement policies, and contract compliance Use pertinent data and facts to identify… more
- Pyramid Consulting, Inc. (Wolfforth, TX)
- …, or community setting and 1+ years of case management experience in a managed care setting. Knowledge of utilization management principles and healthcare ... Care Manager (RN) . This is a 06+months contract opportunity with long-term potential and is located in...managed care . Experience with medical decision support… more
- BCforward (Tampa, FL)
- …School diploma or GED Experience: Minimum 1-2 years in a healthcare or managed care setting Preferred: Previous remote work experience Ideal Candidate Profile: ... II Location: Tampa, Florida (Remote) Expected Duration: 6 months, Contract -to-Hire Target Start date: ASAP Schedule: Monday - Friday,...Must-Haves: 2+ years in a healthcare or managed care setting Comfortable with high-volume inbound… more
- Lakeland Care, Inc. (Fond Du Lac, WI)
- …on creating a world we all want to live in. With long-standing roots as a managed care organization (MCO), we provide long-term care services to eligible ... our award winning culture as we serve members in your area! Position Summary: The Care Manager (CM), as part of an interdisciplinary team (IDT) with a RN Care… more
