- Waystar (Atlanta, GA)
- **ABOUT THIS POSITION** The Payer Relations Specialist is responsible for initiatives to identify and build contractual relationships with payers for direct data ... connections with those payers. As a key member of the Waystar payer relations team, the Payer Relations Specialist will drive new value for Waystar's… more
- BD (Becton, Dickinson and Company) (Warwick, RI)
- …Become a **maker of possible** with us. **Job Overview:** The **Senior Manager - Payer Relations , Market Access (PRMA)** is a very important customer-facing role ... Senior Manager is the key contact responsible for local market access and payer relations related matters across the US and will have responsibility for leading… more
- Walmart (Bentonville, AR)
- …**About the team:** The Payer Programs team is part of the broader Payer Relations team that supports the Health and Wellness business unit. Payer ... across Health & Wellness teams, including operations, marketing, legal, and government relations , to support business objectives and payer strategies. + Analyze… 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
- CommonSpirit Health (Phoenix, AZ)
- …implementation and management of PSR system standards for contracting and payer relations on a divisional level. Accountabilities include: implementing ... implementation and management of PSR system standards for contracting and payer relations . Accountabilities include: ensuring that managed care contracts… more
- Scripps Health (San Diego, CA)
- …of all managed care agreements. Establish effective lines of communication between Payer Relations and Patient Financial Services, Business Services, and Scripps ... in strategy development for Scripps Health/Scripps Health Plan Services payer contracting. #LI-EE1 *Required Education/Experience/Specialized Skills:* **Bachelor's degree plus… more
- CommonSpirit Health (Phoenix, AZ)
- …implementation and management of PSR system standards for contracting and payer relations . Accountabilities include: ensuring that managed care contracts ... **Responsibilities** **Job Summary / Purpose** The Region Contract Manager for Payer Strategy & Relationships (PSR) assists PSR leaders in the development,… more
- Walmart (Bentonville, AR)
- …Billing and Revenue Cycle Management, and Enrollment Services teams within Health & Wellness Payer Relations . What You'll Bring: + Ability to manage projects and ... influence cross-functional teams + Experience in contract review, business strategy, and/ or data interpretation + Curiosity and adaptability to new technologies (for example, AI) + Excellent written and verbal communication skills + Proficiency in Microsoft… more
- Cedars-Sinai (Los Angeles, CA)
- …Summary The Director of Managed Care develops and implements managed care and payer relations strategies including contract negotiation and management of ... and procedural/surgery centers. Responsible for negotiating insurance contracts and payer agreements that enable Cedars-Sinai to meet its financial objectives… 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
- Amazon (Boston, MA)
- 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
- 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
- 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
- Houston Methodist (Houston, TX)
- …Care Contracting position is responsible for the development, negotiation, maintenance and payer relations of the Houston Methodist (HM) contracts for ... pricing, rate structures, addendums, and language requirements. + Analyzes and manages payer quality metric bonus and risk programs in conjunction with internal… more
- WellSpan Health (York, PA)
- …Commission. Serves as a key liaison among hospitals, ambulatory practices, payer relations and executive leadership. **Duties and Responsibilities** **Essential ... efficient verification of provider credentials in alignment with organizational policies, payer requirements and accreditation standards, such as those from NCQA,… more
- Community Health Systems (Franklin, TN)
- …clinical, and operational teams to address contract compliance issues and enhance payer relations . + Maintains knowledge of medical coding systems, reimbursement ... financial and clinical teams to improve revenue cycle processes and optimize payer relationships. As a Payment Compliance Analyst at Community Health Systems (CHS)… more
- Walmart (Bentonville, AR)
- …reduce cost-to-collect. + Serve as a key liaison with H&W Operations, Finance, and Payer Relations . . + Present AR performance, risk assessments, and strategic ... optimizing reimbursement cycles, and driving enterprise-wide improvements in cash flow and payer performance. **What you'll do:** + Develop and execute the strategic… more
- HCA Healthcare (Bradenton, FL)
- …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
- Affordable Care (Morrisville, NC)
- …compliance and maximizing collections through effective claims management, patient billing and payer relations . The ideal candidate brings deep expertise in ... + **Compliance & Reporting** + Monitor compliance with dental coding (CDT), payer policies, HIPAA regulations and other relevant guidelines. + Oversee audits and… more
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