- BlueCross BlueShield of North Carolina (NC)
- **Job Description** The Strategic Advisor , Healthcare plays a crucial role in assisting with complex analysis, evaluation, and planning to achieve the organization's ... includes new forms of healthcare reimbursement, healthcare redesign consultation, payer /provider engagement, and market offer opportunities. Underwriting experience is… more
- Novant Health (Winston Salem, NC)
- …goals and objectives for assuring the effective, efficient utilization of health care services. The Physician Advisor will have the responsibility of ... Summary Novant Health is looking for a System Physician Advisor to join their Safety & Quality Institute. This... care progression, denial management pertaining to post-acute care disposition, compliance with governmental and private payer… more
- AdventHealth (Altamonte Springs, FL)
- …we are even better. **Shift** : Full-time; Monday -Friday **Job Location** : Remote **The role you will contribute:** The role of the Utilization Management (UM) ... legitimacy of hospital admission, treatment, and appropriate level of care . The UM RN utilizes key clinical data points...UM nurse is responsible for escalation to the Physician Advisor or designated leader for additional review as determined… more
- Ochsner Health (New Orleans, LA)
- …and operational oversight. It is responsible for analyzing and resolving payer denials and underpayments, implementing KPIs, and developing data-driven strategies to ... of strategic data assets while serving as a technical advisor and liaison to internal and external stakeholders. To...not called upon to perform or assist in emergency care or first aid. There is no occupational risk… more
- Takeda Pharmaceuticals (Boston, MA)
- …required; biopharma market access experience highly preferred + Understanding of US payer market dynamics and how managed care organizations make decisions ... Access and Channel Strategy, you will act as a thought-leader and trusted advisor on pipeline and inline product strategy by determining portfolio considerations and… more
- UNC Health Care (Chapel Hill, NC)
- …conditions, patient safety indicators, hierarchical condition categories and complexity of care rendered to all patients. Educates on proper creation of provider ... CPT codes in accordance with the Official Coding Guidelines, and third party payer , state and federal regulations. 10. Identifies cases for CDI Physician Advisor… more
- BlueCross BlueShield of North Carolina (NC)
- …with Salesforce, Genesys Cloud, Nuxeo, and Facets As a technical leader, trusted advisor , and partner you will guide senior company leadership to ensure coherent ... Our work as technology specialists pushes the boundaries of what's possible in health care . You will help build solutions that make a real difference in people's… more
- Arnot Health (Elmira, NY)
- Job Description Remote work available! Up to $10,000 Sign on Bonus for qualified Case Managers! MAIN FUNCTION: The Case Management (denial/prior auth) will review ... and trend, record and collect patient accounts denied by payer . Under the direction of the System Director of.... Under the direction of the System Director of Care Coordination coordinates data with other Arnot Health departments… more
- Cardinal Health (Columbus, OH)
- …(TM) Access and Patient Support helps specialty pharmaceutical manufacturers remove barriers to care so that patients can access, afford and remain on the therapy ... better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class...other analyses as assigned + Acts as a trusted advisor to the APS team + Audits IT processes… more