- Rady Children's Hospital San Diego (San Diego, CA)
- JOB SUMMARY: Responsible for seeking contract opportunities, reviewing contract language and terms, conducting data analysis on financial terms, negotiating ... problem resolutions regarding payment issues with all contracted payors. Manages the contract review process for RCSSD 3rd party contracts, contracts with payors,… more
- CommonSpirit Health (Rancho Cordova, CA)
- …and have California physician contract experience. **Job Summary:** The Contract Specialist Divisional Payers Payer Strategy & Relationships (PSR) works ... to support the negotiation of terms and conditions for Managed Care payer contracts for facility professional...to ensure the terms and conditions of the payer contract adhere to the CSH Standards and Guidelines represent… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …collections of outstanding account balances for commercial, government, and managed care payors as assigned. The Reimbursement Specialist I is required to ... their leadership. It is a requirement for the Reimbursement Specialist I to read, interpret and apply complex payor... I to read, interpret and apply complex payor contract language to expected reimbursement calculations and pursue all… more
- Sharp HealthCare (San Diego, CA)
- …in Healthcare Management, Business, or other degree acceptable with combination of education and managed care experience. + 3 Years experience in a managed ... apply knowledge as part of day-to-day job responsibilities. + Knowledge of managed care principles, reimbursement methodologies, and healthcare delivery systems.… more
- Veterans Affairs, Veterans Health Administration (Fresno, CA)
- …Medicine Specialist is trained and certified to provide comprehensive care for addiction and substance related disorders, including the diagnosis, treatment, and ... and in-patient settings. Responsible for providing the Addiction Medicine component of patient care to patients managed by the Pain clinic and those patients… more
- Prime Healthcare (Lynwood, CA)
- …, Account Resolution is the lead responsible for the timely follow-up of Managed Care /Commercial accounts. Communicates clearly and efficiently by phone with ... and reports. Responsible to obtain State collection guidelines if applicable. Reviews managed care contracts. Qualifications + Minimum of four years hospital… more
- Sharp HealthCare (San Diego, CA)
- …requirements and quality standards are being monitored effectively.Maintain an understanding of basic managed care concepts and principles including Managed ... business practices. **What You Will Do** The Provider Relations Specialist is responsible for the development and maintenance of...or Equivalent + 4 Years experience in the health care field with particular emphasis on physician network, physician… more
- TEKsystems (Northridge, CA)
- …The ideal candidate will possess a strong understanding of medical terminology, managed care , and medical office operations. Location: Northridge, CA 91324 ... HMOs. + Ensure compliance with all regulatory standards and managed care requirements. + Maintain up-to-date records...Level + Intermediate Level Job Types + Full-time + Contract + Temporary Benefits + 401(k) + Dental insurance… more
- Centene Corporation (Sacramento, CA)
- …equivalent experience. 4+ years of provider relations or contracting experience in health care , managed care , Medicare or Medicaid services environment. ... new provider orientations and educate providers regarding the provider manual, and contract requirements. Serves as a resource for department staff and provides… more
- Emanate Health (Covina, CA)
- …preferred. Experience within an acute hospital setting, with strong emphasis on managed care contract and appeals/underpayment collection activities. ... at Emanate Health plays a vital role in the care we deliver. No matter what department you belong...Knowledge of networks, IPA's, HMO's, PPO's and PCP's and contract affiliations. Strong analytical skills, proficient with spreadsheets. c.… more
- Pfizer (Sacramento, CA)
- …leaders or high influence customers in large group practices, hospitals, or managed care organizations preferred. + Strong organizational and analytical skills ... + Present terms of sale of product or existing contract terms where appropriate and with approved language; proactively...obstacles to gain access to difficult to see health care providers and customers. + Cultivate relationships with KOLs;… more
- Ventura County (Ventura, CA)
- …your experience managing repair and maintenance contracts. Give an example of a specific contract /vendor, how you managed the contract , and total cost of ... regarding, building systems and maintenance; corrective and preventive maintenance; contract management; electrical, mechanical, plumbing and indoor environment control… more
- Providence (Mission Hills, CA)
- …of experience in a Provider Relations role working with physicians in a Managed Care /IPA, Medical Group, Health Plan or MSO environment. **Preferred ... Bachelor's Degree in Healthcare Management or related field. + 5 years of Managed care Provider Relations experience. **Why Join Providence?** Our best-in-class… more
- Mass Markets (CA)
- …complete an easy online application and an informal interview with a talent acquisition specialist . If you do not have your equipment, MCI will provide it. You will ... applicant on the basis of age, ancestry, color, family or medical care leave, gender identity or expression, genetic information, marital status, medical condition,… more