- Forvis Mazars (Atlanta, GA)
- Description & Requirements The Managed Care Contracting team assists provider clients (health systems, physician practices, accountable care ... field 3+ years of relevant work experience working in the Payor and/or Managed Care Contracting space Proficient experience in Excel and/ or other analytics… more
- True Find Staffing (TFS) (Memphis, TN)
- …administration, or related field required) 8 years of experience in A/R management or managed care contracting and analysis 8 years directing a ... Review and approve manual adjustments, refunds, and revenue reclassifications. Evaluate proposed Managed Care Contracts, identifying concerns or issues prior to… more
- UF Health (Gainesville, FL)
- …interact with physicians and in management forums. - A demonstrated knowledge of managed care contracting and outcomes and medical reimbursement, including ... commercial payers, federal, and state programs*procedures and guidelines. - Should be able to deal effectively and aggressively with reimbursement issues and represent the financial interests of the University of Florida in a professional and positive manner.… more
- Cedars Sinai (Los Angeles, CA)
- …to service the network's membership. Monitors and Tracks all other aspects of Managed Care , quality & efficiency measures, Star ratings, access, physician ... end user or client acceptance. Well versed within the various components that comprise Managed Care and its key concepts including but not limited to… more
- UnitedHealth Group (Ontario, CA)
- …in. Required Qualifications: High School Diploma/GED (or higher) 3+ years of provider contracting and managed care or medical insurance experience with ... Optum is a global organization that delivers care , aided by technology to help millions of...some tough challenges. Primary Responsibilities: Assist in end-to-end provider contracting claims and helpline onboarding management Assist in the… more
- Intermountain Healthcare (Salt Lake City, UT)
- …residency. Strong health care systems orientation including: managed care , retail and hospital pharmacy, pharmacy contracting , pharmaceutical company ... and dispense controlled substances. Five years of pharmacy practice experience in a managed care or hospital environment. Five years of Pharmacy Benefits… more
- Cigna (Richmond, VA)
- …Experience in developing and managing relationships Understanding and experience with hospital, managed care , and provider business models a plus Team player ... or visit Providers 3 days per week The Provider Contracting Lead Analyst serves as an integral member of...of life. We guide our customers through the health care system, empowering them with the information and insight… more
- US Physical Therapy (Houston, TX)
- …model An understanding of contracting within closed networks Interprets managed care contracts and government reimbursement methodologies to create contract ... This is a dual role that will support the Managed Care Operations Team . The person...Equivalent work experience required Minimum of 3-5 years' experience contracting experience a must. Outpatient Therapy Experience preferred Knowledge… more
- Ewings Associates (Baltimore, MD)
- …experience. Keywords: VP of Revenue Cycle Operations, Director of Revenue Cycle, Managed Care Contract Analyst, Healthcare Financial Analyst, Provider Network ... Care , Reimbursement Modeling, Claims Data Analyst, Contract Negotiation, DRG/APC Modeling, Population Health Analytics, Payer Contracting , Alternative Payment… more
- APLA Health (Los Angeles, CA)
- …with emergency management and preparedness plans and tasks. Assist with grant-funded and managed care organization facility and medical record audits. Promote a ... and performance improvement eClinicalWorks or similar electronic health record system Managed care eligibility and authorization process Public health outcome… more
- Takeda Pharmaceutical Company Limited (Boston, MA)
- …GPO, specialty pharmacy, etc.) Understanding of US payer market dynamics and how managed care organizations make decisions across commercial and public channels ... You will also be responsible for value story development, payer/PBM contracting strategy, pricing, specialty pharmacy and distribution plans, and payer/channel… more
- Sante Health (Clovis, CA)
- …healthcare experience preferred PERFORMANCE REQUIREMENTS Knowledge of office procedures. Knowledge of managed care products such as HMO's and PPO's. Knowledge of ... plans, hospitals, and ancillary providers to ultimately benefit the patient in a managed care environment. Sante Health System provides numerous client services… more
- Molina Healthcare (Long Beach, CA)
- …years clinical practice. 5 years in a Medical Director role. 4 years HMO/ Managed Care experience, including Utilization and/or Quality Program management. 5 ... years managed care administrative experience to include NCQA...years relevant experience Peer Review, medical policy/procedure development, provider contracting experience. Preferred License, Certification, Association Active and unrestricted… more
- Naphcare, Inc. (Birmingham, AL)
- …Headquarters in Birmingham, AL . The Director is responsible for the managed care team including coordinating, evaluating, and overseeing the implementation ... of off-site managed care contracts and network usage. They...management skills. Minimum of 5 years of healthcare reimbursement contracting . Well-developed planning, organizational development, and business skills. Experience… more
- Molina Healthcare (Long Beach, CA)
- …and evidence-based guidelines. Experience in Utilization/Quality Program management HMO/ Managed care experience PREFERRED LICENSE, CERTIFICATION, ASSOCIATION: ... and action plan, which includes strategies that ensure a high quality of patient care , ensuring that patients receive the most appropriate care at the most… more
- Optum NV (Las Vegas, NV)
- …5 STAR; disease-based metrics) in driving/achieving quality outcomes Working knowledge of managed care , and value based medicine Understanding of patient ... (RAF) Preferred Qualifications: 2+ years Quality Management experience Experience within managed care Working with senior leadership team to strategize… more
- Solugenix (Los Angeles, CA)
- …claims audits or claims processing related to Medi-Cal, Cal MediConnect, and/or other managed care product lines similar to client's, client Covered, and ... PPGs, capitated hospitals, and the Plan Partners. This includes all claims processing sub- contracting functions of the delegates. Pay Range for CA, CO, IL, NJ, NY,… more
- Korn Ferry Executive Search (Baltimore, MD)
- …with large-scale research funding and financial management Demonstrated revenue cycle and managed care experience preferred but not required Advanced knowledge ... nurses, and scientists. Above all, JHH aims to provide the highest-quality, expert health care for patients in Maryland and throughout the world. JHH is a 1,154-bed… more
- Assuredpartners (Torrance, CA)
- …with a major consulting/brokerage firm or insurance carrier. Must understand the California managed care market, with knowledge of group underwriting or provider ... contracting principles a plus. Excellent communication skills. Ability to develop and maintain credibility and trust with customers. Analytical and creative. Strong… more
- UnitedHealth Group (Las Vegas, NV)
- …of age OR older 2+ years of work experience in State of California Managed Care environment - IPA, Physician Office, Hospital Administrative, OR other Health ... Optum is a global organization that delivers care , aided by technology to help millions of people live healthier lives. The work you do with our team will directly… more
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