• Industry Enterprise Architect - Healthcare…

    ServiceNow, Inc. (Seattle, WA)
    …to dream big makes for great candidates. ServiceNow is seeking Industry Enterprise Architects with extensive experience with Healthcare Payer organizations to ... patterns for integration + Interact at multiple levels within a healthcare payer organization ( Enterprise Architects, Domain Architects, Directors, VPs, and… more
    ServiceNow, Inc. (08/16/24)
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  • Enterprise Payer Sales Executive

    GetWellNetwork, Inc. (Bethesda, MD)
    Title: Enterprise Payer Sales Executive Reporting to: VP, Sales Opportunity: Get Well seeks a high-energy, driven Enterprise Payer Sales Executive with a ... duties as assigned Requirements: + Previous success as an Enterprise Sales Executive with a minimum 7 years experience...execution with C-Suite required. + Past performance selling to health plan customers will be given priority… more
    GetWellNetwork, Inc. (07/27/24)
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  • VP, Payer Relations

    Scripps Health (San Diego, CA)
    …been with Scripps Health for over 10 years. The Vice President, Payer Relations has enterprise level responsibility for providing strategic and operational ... building provider relationships. **Job:** **Leadership - Executive* **Organization:** **Scripps Health Corp* **Title:** *VP, Payer Relations* **Location:**… more
    Scripps Health (06/26/24)
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  • Consultant - Provider Strategy & Innovation,…

    Guidehouse (Chicago, IL)
    …+ 401(k) Retirement Plan + Basic Life & Supplemental Life + Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts + Short-Term & ... most complex strategic issues across a variety of provider organizations ( health systems, hospitals, physician groups, ACO/CIN, integrated delivery systems, AMCs,… more
    Guidehouse (09/20/24)
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  • Senior Consultant - Provider Strategy…

    Guidehouse (Chicago, IL)
    …+ 401(k) Retirement Plan + Basic Life & Supplemental Life + Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts + Short-Term & ... most complex strategic issues across a variety of provider organizations ( health systems, hospitals, physician groups, ACO/CIN, integrated delivery systems, AMCs,… more
    Guidehouse (09/16/24)
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  • Intern - Provider Strategy & Innovation,…

    Guidehouse (Chicago, IL)
    …+ 401(k) Retirement Plan + Basic Life & Supplemental Life + Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts + Short-Term & ... most complex strategic issues across a variety of provider organizations ( health systems, hospitals, physician groups, ACO/CIN, integrated delivery systems, AMCs,… more
    Guidehouse (09/09/24)
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  • Enterprise Shared Services Program Manager…

    LA Care Health Plan (Los Angeles, CA)
    …$117,509.00 (Min.) - $152,762.00 (Mid.) - $188,015.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created by the state of ... Enterprise Shared Services Program Manager II Job Category:...County residents. We are the nation's largest publicly operated health plan . Serving more than 2 million… more
    LA Care Health Plan (09/11/24)
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  • Enterprise Business Analyst- Product…

    Brighton Health Plan Solutions, LLC (Westbury, NY)
    …Analyst in the healthcare payer domain with Multi-employer Trust or Health Plan administration of self-funded client who excels in client interactions, ... in Multi-employer Trust (Hours & Eligibility management, Contribution Accounting) or Health Plan Administration (Benefits & Claims Administration, Vendor… more
    Brighton Health Plan Solutions, LLC (07/31/24)
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  • Enterprise Application Security Architect

    Blue Cross Blue Shield of Massachusetts (Boston, MA)
    …, Blue Cross Blue Shield of Massachusetts is a community-focused, tax-paying, not-for-profit health plan headquartered in Boston. We have been a market leader ... enterprise -level solutions. Prior experience focusing on the healthcare payer space is a plus. They will be responsible...years, and are consistently ranked among the nation's best health plans. Our daily efforts are dedicated to effectively… more
    Blue Cross Blue Shield of Massachusetts (07/17/24)
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  • SVP, Internal Audit & Enterprise Risk…

    Commonwealth Care Alliance (Boston, MA)
    …of experience in healthcare industry with strong preference for health insurance, health plan , payer , managed care, and government programs (eg, ... to Us:** The Senior Vice President, Internal Audit & Enterprise Risk Management (Remote) will lead the company's Internal...+ Reviews business processes/procedures and evaluates controls in the health plan and clinical operations of CCA.… more
    Commonwealth Care Alliance (09/04/24)
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  • Physician Billing Reimbursement and Contract…

    Catholic Health Services (Melville, NY)
    Overview Catholic Health is one of Long Island's finest health and human services agencies. Our health system has over 16,000 employees, six acute care ... hospitals, three nursing homes, a home health service, hospice and a network of physician practices across the island. At Catholic Health , our primary focus is… more
    Catholic Health Services (08/22/24)
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  • Head of Patient Value and Access, US Oncology

    Takeda Pharmaceuticals (Boston, MA)
    …managed care, Medicare Part D drug plans, all third party commercial payer , including health maintenance organizations (HMOs) and preferred provider ... of strategies and business plans that meet the evolving payer , provider and patient needs. As the leader, you...capabilities and current landscape knowledge. + Develop an evidence-based plan , informed by market research and advisory boards to… more
    Takeda Pharmaceuticals (09/14/24)
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  • Director, In-line Brands - Global Health

    Teva Pharmaceuticals (Parsippany, NJ)
    Director, In-line Brands - Global Health Economics, Value, and Outcomes Date: Sep 4, 2024 Location: Parsippany, United States, New Jersey, 07005 Company: Teva ... are** Together, we're on a mission to make good health more affordable and accessible, to help millions around...dossiers. ⦁ The individual will develop the evidence generation plan and provide GHEVO input to the US brand… more
    Teva Pharmaceuticals (09/05/24)
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  • Data Governance Program Manager I

    LA Care Health Plan (Los Angeles, CA)
    …$105,267.00 (Min.) - $122,000.00 (Mid.) - $173,689.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created by the state of ... to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan . Serving more than 2 million members, we make sure our… more
    LA Care Health Plan (06/26/24)
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  • Executive Director, Integrated Account Management…

    Merck (North Wales, PA)
    …and as such, is a critical partner to the US marketing teams, access and payer marketing as they develop and evolve their US Market Access product strategies. The ... above-brand customer strategies & engagement including IDN, GPOs, Specialty Pharmacy, PBMs, Health Plans, Employers, as well as new segments evolving in response to… more
    Merck (09/21/24)
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  • Vice President, Population Health

    Hudson Headwaters Health Network (Queensbury, NY)
    …the oversight and direction for designing, implementing, and supporting robust, enterprise -wide population health management capabilities. In addition to ... years of accomplished management experience in a healthcare provider, payer , association, or vendor setting + Demonstrated ability to...a strategic plan and execute on that plan + Experience with major health information… more
    Hudson Headwaters Health Network (09/14/24)
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  • Director Behavioral Health Programs…

    Elevance Health (Topeka, KS)
    …(SUD). Ensures that operational needs are met and ensures compliance with state/federal health plan requirements, Medicare guidelines and health plan ... in the design of strategic plans and management of enterprise -wide, large-scale clinical initiatives, pilots, and projects promoting quality...and minimum of 10 years of experience in behavioral health setting, either provider or payer ; or… more
    Elevance Health (09/17/24)
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  • Managing Director of Pharmacy Product Strategy-…

    The Cigna Group (St. Louis, MO)
    …This role is responsible for strategy and execution of the pharmacy's payer , patient, pharma, and prescriber strategy, pricing, communications, payer programs ... situations and evolving federal and state regulated markets. + Enterprise thinker with proven ability to influence and challenge...incorporate them into both a short-term and long-term organizational plan . + Have breadth and depth of knowledge in… more
    The Cigna Group (09/14/24)
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  • Outpatient Denial/Appeals Specialist- RN

    Carle (Urbana, IL)
    …and manage clinical and prior authorization denial appeals for the Carle enterprise . Represents Carle in clinical meetings and writing appeals on outpatient accounts ... post payment reviews where medical necessity is being challenged. Responsible for enterprise wide outpatient clinical review and appeals on Medicare and Medicaid… more
    Carle (08/23/24)
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  • Revenue Cycle Analyst - PFS Billing Services

    Scripps Health (San Diego, CA)
    …merging patient records. Responsible for monitoring of Access related Databases including MPI, Payer / Plan database etc. in order to reduce misuse or redundancy. ... problems. * Able to adapt, prioritize and meet deadlines. * Knowledge of payer contracts, medical terminology, commercial and government health insurance and… more
    Scripps Health (06/25/24)
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