- CVS Health (Wellesley, MA)
- …more compassionate. And we do it all with heart, each and every day. **Director, Payer Relations ** **Position Summary** The Director, Payer Relations ... and contract compliance. **Required Qualifications** + Demonstrated experience leading a payer or provider relations organization, including responsibility for… more
- CVS Health (Hartford, CT)
- …The Lead Director supervises manager and Sr. Manager of Provider Contracting/ Relations . Provides strategic leadership and oversight for network management and ... provider relations . Develops and implements network strategies. Manages provider contracts...relationships and interactions with various healthcare payers related to payer contracting. + Establishes agreements on reimbursement rates, formulary… more
- Rush University Medical Center (Chicago, IL)
- …consultation with Rush Health business and support departments (Clinical, Analytics, HIT, Payer Relations , Legal, Finance). + This includes legal, compliance, ... implementation of FFS and VBC contracts for Members. + Work closely with Payer Relations to ensure all fee schedules and Contract Summaries on the Rush Health… more
- Arkansas Children's (Little Rock, AR)
- …field of study. **Required Work Experience:** Related Field - 3 years managed care, payer relations , payer contract, or physician or hospital billing ... Friday, 8:00 am - 5:00 pm - Hybrid The Payer Contract Specialist is responsible for managing payer... Payer Contract Specialist is responsible for managing payer contracts to ensure alignment with the organization's strategic… more
- Sharp HealthCare (San Diego, CA)
- …executive leadership team on emerging trends and methodologies in contracting and payer relations ; support Chief Financial Officers, Presidents of the Medical ... for new contract consideration and existing contract renegotiations. Foster payer relationships between contracting cycles to develop ongoing, positive connections… 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 (Brentwood, TN)
- …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
- BD (Becton, Dickinson and Company) (Stuart, FL)
- …to support the priority objectives. + Subject matter expert in all areas of payer relations and is highly-skilled in payer -related communications. + Oversees ... National Director of Payor Strategy and Market Access and Payer Strategy, reports to the General Manager of LMS,...development and execution of the payor, managed care, and payer contracting medical policy initiatives in collaboration with BD's… 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
- J&J Family of Companies (Cincinnati, OH)
- …but not limited to, local market access initiatives, integrated payer -provider relations strategies, reimbursement/market access assessments, reimbursement ... **We are searching for the best talent for** **an Associate Director, HEMA Provider Relations - MedTech Surgery.** This is a field-based remote role in the Preferred… more
- CVS Health (Woonsocket, RI)
- …and rate reconciliation data to deliver clear, actionable insights and reporting to our Payer Relations partners and external PBM clients. An individual in this ... cadence. Analysts will manage PBM impact in close coordination with the broader Payer Relations Financial Planning and Analysis team, as well as Payer … more
- AdventHealth (Maitland, FL)
- …+ 4 of experience in managed care, patient financial services or healthcare payer relations background Required . Certification in HB Resolute Epic Contract ... coding knowledge Preferred . 5 in healthcare, hospital revenue cycle or payer /provider relations Preferred Our people are passionate about what they do, the… more
- University of Rochester (Rochester, NY)
- …global transplant payments and initiates transfer of dollars to each provider. 10% Payer Relations + Identifies need for in-person meetings and phone conferences ... staff and outside agencies regarding contractual obligations. Assures on-going positive relations and support of highly visible unique contracts and arrangements.… 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
- CVS Health (Woonsocket, RI)
- …of Pharmacy Reimbursement Strategy and Analytics is a key role in the Payer Relations FP&A organization. With the constantly evolving Pharmacy Reimbursement ... quantify the value of contract opportunities, benchmark performance, and collaborate with the Payer Relations team to inform negotiations. The Manager will also… 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
- Amazon (Seattle, WA)
- Description Amazon Pharmacy Payer Relations is seeking a driven, talented, and experienced to play a critical role in B2B Business Development working with large ... also driving member adoption of Amazon Pharmacy About the team Payer relations business development is part of Amazon Pharmacy Partener Services, representing… more
- Community Health Systems (Franklin, TN)
- …in care management preferred + 1-2 years of experience in utilization management, payer relations , or hospital revenue cycle preferred **Knowledge, Skills and ... hospital resource utilization, reduce readmissions, and maintain compliance with payer requirements. **Essential Functions** + Performs admission and continued stay… 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
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