- iCare Health Solutions Enterprise (Miami, FL)
- …in the NextGen Contract Utility, supporting both traditional fee-for-service (FFS) reimbursement and managed care models, including capitated, global ... , revenue cycle, or payer relations Expert knowledge of both fee-for-service and managed care reimbursement models, with direct experience managing capitated… 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
- 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
- CSI Pharmacy (Nash, TX)
- …information Manages the tracking, approval, administration, and post-implementation process of all managed care contracts throughout contract life cycle ... both payors and providers Responsible for all aspects of managed care and direct revenue contract...existing relationships with third party payers to ensure competitive reimbursement rates and contract language attainable through… more
- Optum (San Juan, PR)
- …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...recoveries Ensure adherence to state and federal compliance policies, reimbursement policies, and contract compliance Use pertinent… more
- Ivy Rehab Network (White Plains, NY)
- … contract negotiations with commercial payers, Medicare Advantage plans, Medicaid managed care organizations, and other third-party payers Analyze market ... supporting reimbursement agendas at the state and national level Contract Management and Negotiation Oversee negotiation, execution, and ongoing management of… more
- TAJ Technologies (San Diego, CA)
- …collections of outstanding account balances for commercial, government, and managed care payors as assigned. The Reimbursement Specialist I is required to ... Specialist I to read, interpret and apply complex payor contract language to expected reimbursement calculations and pursue all payments due to the organization.… more
- Compass Group (New York, NY)
- …sanitation, food cost controls, and presentation Previous P&L accountability or contract - managed service experience is desirable Strong supervisory, leadership, ... Other Forms of Compensation: Flexible Paid Time Off, Travel Reimbursement , Benefits, 401K, Training Pay Grade: Morrison Healthcare is...operation of Food & Nutrition Services in an Acute Care Hospital. The Traveling Associate Director of Food and… more
- Compass Group (Buffalo, NY)
- …food cost controls, and presentation + Previous P&L accountability or contract - managed service experience is desirable + Strong supervisory, leadership, ... Other Forms of Compensation: Flexible Paid Time Off, Travel Reimbursement , Benefits, 401K, Training Morrison Healthcare is a leading...operation of Food & Nutrition Services in an Acute Care Hospital. The Traveling Associate Director of Food and… more
- CLS Health (Webster, TX)
- …Payor Contracting Supervisor to lead the negotiation, implementation, and oversight of managed care agreements across our 35+ locations and 200+ providers. ... Administration, Finance, or related field Minimum 5 years of experience in managed care contracting, including direct payer negotiation Strong knowledge of… more
- MetroPlusHealth (New York, NY)
- …list of products, including, but not limited to, New York State Medicaid Managed Care , Medicare, Child Health Plus, Exchange, Partnership in Care ... Empower. Unite. Care . MetroPlusHealth is committed to empowering New Yorkers...overpayment or underpayment due to claim processing system issues, contract amendments, processing errors, or other issues. This position… more
- PacificSource (Portland, OR)
- …SUCCESS PROFILE Work Experience: Minimum five (5) years of experience in the health care , managed care , or the NEMT industry required. Experience with ... Medicaid programs and managed care strongly preferred. Education, Certificates, Licenses: Bachelor's degree in business, health care administration, or a… 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. Staffed with over 500 employees and… more
- MedPro Healthcare Staffing (Downey, CA)
- …as a liaison between the patient's family and healthcare organization Strives to promote self- managed care and the use of healthcare resources in the most ... healthcare clients. Requirements Eighteen months of recent experience in an Acute Care Case Manager setting Active RN License BLS Certifications Degree from… more
- Cigna (Independence, OH)
- …Intimate understanding and experience with larger, more complex integrated delivery systems, managed care , and provider business models. Team player with proven ... impact of high spend or increasingly complex provider contracts and alternate contract terms. Manages key provider relationships and is accountable for interface… more
- Banner Health (Phoenix, AZ)
- …Educates other health care providers, payors and patients on concepts of managed care , managed care networks, transplant networks, individual ... Phoenix, Arizona Department Name: Pre-Heart Trans-Hosp Work Shift: Day Job Category: Clinical Care Better Than Ever for Nurses. Nurses are the heartbeat of health … more
- Raytheon Technologies (Marlborough, MA)
- …as only US citizens are authorized to access information under this program/ contract . Security Clearance: None/Not Required Raytheon Company, Managed by Collins ... retirement contribution, including a Lifetime Income Strategy option Tuition reimbursement program Student Loan Repayment Program Life insurance and disability… 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 ... care team members on current healthcare issues impacting practice patterns and reimbursement . *Educates physicians and health care team on observation status,… more
- Tiburcio Vasquez Health Center (Hayward, CA)
- …to the centralized billing team responsible for Medicare, Medi-Cal, Private Insurance, Managed Care , and other third-party billing and collections for all ... Flexible Spending Accounts, retirement plan with an Employer match, tuition reimbursement , monthly treats, pet insurance and more. Tiburcio Vasquez Health Center… more
- Alignment Healthcare (San Diego, CA)
- …Experience: 10 years of experience in managed care or health care field, including a strong understanding of reimbursement methodologies, contract ... care finance and contracts Strong knowledge of Medicare managed care and associated contract language Excellent interpersonal and relationship… more
