- Novo Nordisk Inc. (Plainsboro, NJ)
- About the Department Novo Nordisk's Market Access and Public Affairs team engages diverse stakeholders across political and healthcare landscapes to forge solutions ... relationships, and differentiates Novo Nordisk products in the marketplace, with targeted payer accounts that influence patient access and care. Targets include a… more
- Albany Medical Center (Albany, NY)
- …programmatic, financial, and employee related activities, as applicable, under the System Payer Contracting Unit. The Director prepares annual budget target ... Department /Unit: Integrated Delivery Systems Work Shift: Day (United...and other stakeholders. The Director possesses deep marketplace and payer contracting expertise to meet the high… more
- Arkansas Children's (Little Rock, AR)
- …on political, legal, and regulatory trends/developments impacting managed care and payer contracting . 3. **Relationship Management** Track and communicate ... 1. **Financial and Performance Oversight:** Analyze and monitor existing and proposed payer reimbursement schedules to support contracting strategies. Manage and… more
- Walgreens (Deerfield, IL)
- …Company information is available at www.walgreensbootsalliance.com **Job ID:** 1639886BR **Title:** Manager , B2B Customer Success - Payer **Company Indicator:** ... **Job Description:** **Job Summary** The Manager of B2B Customer Success plays a critical role in ensuring our Business to Business (B2B) clients receive the highest… more
- Henry Ford Health System (Troy, MI)
- GENERAL SUMMARY: The Transaction Flow Manager leads a dedicated consultative support team that partners with Patient Access, Central Authorization, Insurance ... monitor every transaction from the first patient encounter through final payer adjudication. The team delivers deep analytics, root-cause investigations, and… more
- Molina Healthcare (Riverside, CA)
- …California _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with ... with all relevant federal, state and local regulations. Responsible for contracting /re- contracting of Complex contracts with Alternative Payment Methods… more
- PeaceHealth (Vancouver, WA)
- …all regulatory agencies including JCAHO, CMS and are HIPAA compliant. + Collaborates with Payer Contracting to report payer lags and provide Payer ... supervisors and caregivers to ensure billing and follow-up activities coincide with department goals and lead to achievement of monthly KPIs. Continually review,… more
- Corewell Health (Grand Rapids, MI)
- Job Summary - Manager , Payment Integrity Seeking a strategic and results-driven leader to join Priority Health as a Manager , Payment Integrity. This role is ... You will lead cross-functional efforts, ensuring interdependencies across Network Contracting , Utilization Management, and Billing Policy are effectively managed to… more
- Children's Mercy Kansas City (Kansas City, MO)
- …for the patient population, hospital, care delivery model, care management practices, and payer contracting . Supports facilitation and tracking of long length of ... expert at the roles of Clinical Review Nurse Care Manager and Care Coordination Case Manager and...appeal, and final appeal outcome to identify and resolve insurance/ payer issues; clinical care delivery concerns; Care Coordinator performance… more
- LifePoint Health (Las Cruces, NM)
- …visits, colonoscopies, cervical cancer screenings, and mammograms. The Quality Practice Manager (QPM) will collaborate with employed practices to achieve local ... position collaborates with Credentialing, Care Management, technology platform, and payer representatives as appropriate. *_Responsibilities:_* Collaborate with various practices… more
- Grifols Shared Services North America, Inc (Raleigh, NC)
- …would be available to provide any necessary support to the responsible National Account Manager (NAM) in the execution of the contracting process + Understand ... targeted Health System which may include various Heads of Department , KOL's and Key Decision Makers / Influencers both...resources to assist the customer (ie Director of Reimbursement, Payer Team, etc ) + Compliantly engage and interact… more
- Elevance Health (Durham, NC)
- **Program Manager -Children and Family Specialty Plan Network** _We are partnering with North Carolina DHHS to operationalize a statewide Medicaid Plan designed to ... a regionalized provider engagement model covering each of the seven (7) Department of Social Services (DSS) administrative regions across North Carolina. **North… more
- City of New York (New York, NY)
- …Health Systems seeks to hire a Healthcare Payment and Financing Innovation Manager . This position will be responsible for conducting payment, financing and ... experience, with demonstrated expertise in at least one of the following: Contracting , Invoicing, payment and financing experience at local, state, and/or federal… more
- Sumitomo Pharma (Columbia, SC)
- …highly motivated, and experienced individual for the position of Sr. Manager , Medicaid Contract Administration. This position is responsible for managing the ... a detailed understanding of the life science industry specific to the Medicaid payer landscape. The decisions made in this position affect company sales, pricing… more
- BrightSpring Health Services (Englewood, CO)
- …of Amerita's credit balances, processing incoming/outgoing correspondence, medical records , payer /patient refunds, payer audits, appeals, and providing Revenue ... Ancillary Services Team Lead will ensure that the Revenue Cycle Management department maintains compliance with company policies and all applicable laws and… more
- University of Rochester (Rochester, NY)
- …on business, market growth, service development and payor/PBM strategies. + Participates with payer contracting leaders of the health system in the evaluation ... Regular Time Type: Full time Scheduled Weekly Hours: 40 Department : 500160 Pharmacy SMH Work Shift: UR - Day...with State and Federal Regulations, accreditation standards and third-party payer requirements for the purpose of minimizing risk and… more
- Elevance Health (Concord, NC)
- …Regional Specialty Provider Liaisons must reside and work within the aligned Department of Social Services (DSS) administrative region. This position will support ... working with providers and internal teams to ensure timely provider contracting , education on specialty topics, developing value-based payment strategies, and… more
