- CVS Health (Buffalo Grove, IL)
- …it all with heart, each and every day. **Position Summary:** The Executive Director, Payer Relations Analysis will act as a strategic thought partner for Retail ... Payer Relations . The role will have subject... Payer Relations . The role will have subject matter expertise on...leadership skills to direct cross-functional teams. The Executive Director, Payer Relations Analysis will lead a team… more
- St. Luke's Health System (Boise, ID)
- **Overview** The Manager, Payer Relations & Contracting is a key leadership role accountable for St. Luke's Health System's managed care contract portfolio, to ... activities related to new contract inception, current contract analysis, redline/revisions, payer negotiations, and system level approvals. As an internal expert in… more
- Scripps Health (San Diego, CA)
- …with a stable outlook*from*S&P Global Ratings*due to its strong leadership and financial performance. Why Payer Relations ? The Payer Relations team is a ... of all managed care agreements. Establish effective lines of communication between Payer Relations and Patient Financial Services, Business Services, and Scripps… more
- Ascension Health (El Paso, TX)
- …plans. + Lead or participate in payer negotiation processes and major payer relations discussions. + Maintain knowledge of assigned market(s) or segment(s) ... range at the time of the offer._ **Responsibilities** Oversee payer revenue strategy and contracting for one or more...including the organization's delivery footprint and the payer and competitive environment. Support and integrate business plans… more
- CommonSpirit Health (Rancho Cordova, CA)
- … Payer Strategy & Relationships (PSR) works closely with Divisional Payers the Payer Relations Manager Divisional Directors National PSR team and the PSR ... the negotiation of terms and conditions for Managed Care payer contracts for facility professional and ancillary entities. Primary...is to ensure the terms and conditions of the payer contract adhere to the CSH Standards and Guidelines… more
- University of Rochester (Rochester, NY)
- …balance report - - Over $10,000 report - - Claim Edits - - 10% Payer Relations and Escalation Process - Identify and clarify issues that requirement management ... arrangements, and specialized services. Revenue Collection activities focus on an assigned payer billed at the primary level. Schedule 7:30 AM-4 PM Responsibilities… more
- Ascension Health (Tulsa, OK)
- …offer._ **Responsibilities** The Vice President of Population Health will assist in payer relations , specifically with Community Care of Oklahoma (CCOK), ... execution and continuous improvement. + Serve as a key leader in payer relations , collaborating with CCOK and other payers to enhance value-based care… more
- Sutter Health (Sacramento, CA)
- … payer contract compliance. In addition, this position will support leaders with payer negotiations and payer relations by providing functional support ... Northern California footprint. This position is responsible ensuring successful payer contract implementation across multiple Sutter divisions and develops strong… more
- Methodist Health System (Dallas, TX)
- …ongoing coaching and professional development opportunities for staff members. + **Compliance & Payer Relations :** Stay updated on industry standards, payer ... and maximizing reimbursement. This position requires a strong understanding of payer guidelines, multi-specialty and family physician billing practices, the ability… more
- Mount Sinai Health System (New York, NY)
- …provides necessary follow-up. * Communicates and resolves reimbursement issues to coordinate payer /provider relations between payers and MSHS. * Identifies and ... collection procedures to obtain third party payments and ensure compliance with payer contracts. Ensure accuracy of secondary billing processes and related vendor… more
- Houston Methodist (Houston, TX)
- …President Managed Care position oversees the development, negotiation, and maintenance of payer relations contracts for reimbursement billed through managed care ... optimization and maintenance of the Houston Methodist (HM) managed care payer contracts, the establishment of managed care plan agreements and maintenance… more
- Henry Ford Health System (Detroit, MI)
- …(3) years of experience in health care business operations (eg, payer relations , admissions, billing/coding, authorization etc.), analytics, information ... for Henry Ford Health PCPs. PRINCIPLE DUTIES AND RESPONSIBILITIES: . Manages complex payer member files in conjunction with EPIC reports to reconcile payer … more
- Surgery Care Affiliates (Boise, ID)
- …as opposed from collecting from self-pay individuals. + Works closely with payer provider relations representatives. + Contacting insurance companies by email, ... and collaborate with billing team to resolve. + Understand payer contracts and utilize them for accurate billing and...Customer Interaction: + Provide professional responses to patient and payer inquiries. + Work with patients and providers to… more
- HCA Healthcare (Asheville, NC)
- …member of hospital's peer review committees as requested. Business Development and Payer Relations + Evaluates clinical appropriateness of new medical ... services to facility-level physician credentialing, business development, and provider relations in contracting issues. + Provides medical consultation on… more
- University of Utah Health (Murray, UT)
- …years of experience in the healthcare industry with specific focus in provider or payer relations , provider or payer contracting or communications. + Two ... This position for use in Health Plans Departments only. + The Provider Relations Communications Specialist and Trainer position serves as a liaison between UUHP and… more
- Surgery Care Affiliates (Panama City, FL)
- …Explanation of Benefits received from any payer . + Works closely with payer provider relations representatives. + Has thorough knowledge of ASC Allowable ... cash collection metrics and goals. + Maximized facility reimbursement. + Understands each payer contract and will utilize to ensure payments received are correct. +… more
- Billings Clinic (Billings, MT)
- …needs for program expansion to Manager. * Works closely with Medical Staff, Payer Relations and Patient Financial Services to coordinate needed pre-certification ... * Develops and maintains reference manuals that outline the individual payer requirements as it relates to pre-certification and pre-authorization needs. *… more
- Philips (Plymouth, MN)
- …escalated claims from cross-functional teams, which includes Cash Application Specialists, Payer Relations , Patient Collections, and Reimbursement. + Reviewing ... Working with insurnace carriers to clarify issues related to claims and managing payer prepayment audits. + Addressing inquiries or requests for help in resolving… more
- Gilead Sciences, Inc. (Santa Monica, CA)
- …other related advanced degree + 15+ years of pharmaceutical or biotechnology experience in payer relations with a proven track record of success + Thorough ... with regular travel. **Key Responsibilities** + Direct efforts to develop Kite's payer engagement strategy, and engage with key stakeholders to overcome UM paradigms… more
- Community Health Network (IN)
- …Analyst, in conjunction with the Executive Director of Contract Management and Payer Relations , has responsibility for the development, implementation, and ... developing workflows to ensure accurate receipt of quality performance measures by payer partners. + Ability to work collaboratively with physician practices on… more
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