- Northern Light Health (Brewer, ME)
- …(eg employers) and payers to assure strategic alignment across the Northern Light Health Enterprise . The director reports to the vice president (PSMCO) and ... achieve financial and operational success for the Northen Light Health Enterprise . + Assists in the development...Enterprise . + Assists in the development of a payer strategy that supports the NLH near and long-term… more
- CommonSpirit Health (Houston, TX)
- …new reimbursement methodologies, state specific regulatory issues, plan benefits, payer activity, products and delivery channels including health insurance ... & Innovation team, and other key departments across the enterprise . This position is essential to CommonSpirit Health...related to managed care organizations, physician groups, hospitals and health insurance benefit plan designs + Proven… more
- Northern Light Health (Brewer, ME)
- Northern Light Health Department: Managed Care Contracting Position is located: Cianchette Professional Blding Work Type: Full Time Hours Per Week: 40.00 Work ... come onsite for business needs. Summary: This position supports all aspects of payer contracting and relations working in support of leaders responsible for the… more
- Scripps Health (San Diego, CA)
- …been with Scripps Health for over 10 years. The Vice President, Payer Relations has enterprise level responsibility for providing strategic and operational ... building provider relationships. **Job:** **Leadership - Executive* **Organization:** **Scripps Health Corp* **Title:** *VP, Payer Relations* **Location:**… more
- Somatus (Mclean, VA)
- …and long term cross- payer contracting strategies, such as: broker services, health plan marketing, benefit design integration, high-value network offerings, ... health plan value-reporting and regional, multi- payer initiatives. +...Leadership & Reporting:** + Advise senior leadership and other enterprise -wide stakeholders on payer strategy, positioning, emerging… more
- Walmart (Bentonville, AR)
- Position Summary What you'll do Join the Health & Wellness Payer team as a Director, Analytics supporting Pharmacy and Clinical business. In this role, you will ... role will: + Provide data and modeling for all Payer contracts + Collaborate with Teams across Payer...analytics in Pharmacy and Medical with PBMs, Retail, and/or Health Plans, managing complex projects cross-functionally. + You possess… more
- Guidehouse (Chicago, IL)
- …+ 401(k) Retirement Plan + Basic Life & Supplemental Life + Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts + Short-Term & ... most complex strategic issues across a variety of provider organizations ( health systems, hospitals, physician groups, ACO/CIN, integrated delivery systems, AMCs,… more
- LA Care Health Plan (Los Angeles, CA)
- …$117,509.00 (Min.) - $152,762.00 (Mid.) - $188,015.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created by the state of ... Enterprise Shared Services Program Manager II (Limited Duration-...County residents. We are the nation's largest publicly operated health plan . Serving more than 2 million… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- …or equivalent experience. + BA Certifications and or PMP a plus. About At Brighton Health Plan Solutions, LLC, our people are committed to the improvement of how ... your authentic self to work with all of your unique abilities. Brighton Health Plan Solutions partners with self-insured employers, Taft-Hartley Trusts, … more
- Commonwealth Care Alliance (Boston, MA)
- …of experience in healthcare industry with strong preference for health insurance, health plan , payer , managed care, and government programs (eg, ... to Us:** The Senior Vice President, Internal Audit & Enterprise Risk Management (Remote) will lead the company's Internal...+ Reviews business processes/procedures and evaluates controls in the health plan and clinical operations of CCA.… more
- ServiceNow, Inc. (Los Angeles, CA)
- …We also offer health plans, including flexible spending accounts, a 401(k) Plan with company match, ESPP, matching donations, a flexible time away plan ... to dream big makes for great candidates. ServiceNow is seeking Industry Enterprise Architects with extensive experience in Retail organizations to join our team.… more
- HCA Healthcare (Brentwood, TN)
- …and support of Physician Services' (PSG) provider-based government and commercial value-based payer programs. The programs the AVP will have oversight for include ... (ACO); Advanced Alternative Payment Models (AAPM); Medicare Advantage; and commercial payer value programs. This position will have particular emphasis on overseeing… more
- Rush University Medical Center (Chicago, IL)
- …EPIC have accuracy focused on deposit date, appropriate payment source, payment code, payer plan , allowed amounts and remit codes when applicable. *Demonstrate ... **Location:** Chicago, IL **Hospital:** RUSH University Medical Center **Department:** SBO Enterprise Services **Work Type:** Full Time (Total FTE between 0.9 and… more
- Teva Pharmaceuticals (Parsippany, NJ)
- Director, In-line Brands - Global Health Economics, Value, and Outcomes Date: May 14, 2024 Location: Parsippany, United States, New Jersey, 07005 Company: Teva ... are** Together, we're on a mission to make good health more affordable and accessible, to help millions around...dossiers. ⦁ The individual will develop the evidence generation plan and provide HEOR input to the US brand… more
- CVS Health (Monroeville, PA)
- Bring your heart to CVS Health . Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health . This purpose ... guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose… more
- LA Care Health Plan (Los Angeles, CA)
- …$105,267.00 (Min.) - $122,000.00 (Mid.) - $139,000.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created by the state of ... to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan . Serving more than 2 million members in five health… more
- LA Care Health Plan (Los Angeles, CA)
- …$91,536.00 (Min.) - $121,286.00 (Mid.) - $136,000.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created by the state of ... to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan . Serving more than 2 million members in five health… more
- Fairview Health Services (St. Paul, MN)
- …likely ICD and CPT codes and/or utilize available coding resources. + Screen payer medical policies to determine if the service meets medical necessity guidelines. + ... and admission and discharge notification requirements are met per payer guidelines. + Facilitate insurance denial mitigation steps such...manner. + Ensures a safe, secure environment. + Individualizes plan of care to meet patient needs. + Modifies… more
- CVS Health (Woonsocket, RI)
- …supporting annual planning exercises, and ensuring financial planning and billing processes for Health Plan and other clients. You will build reporting and ... Bring your heart to CVS Health . Every one of us at CVS ...essential. You will demonstrate this by working across the enterprise with IT, Finance, Enterprise Analytics, and… more
- Trinity Health (Syracuse, NY)
- …and Defend against federal and payer audits, malpractice litigation, and health plan denials Compare evaluation and management code utilization by provider, ... **Employment Type:** Full time **Shift:** **Description:** Mission Statement **:** .We, St Joseph's Health and Trinity Health , serve together in the spirit of… more