- Humana (Trenton, NJ)
- …our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... the Pricer Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support… more
- Humana (Trenton, NJ)
- …part of our caring community and help us put health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part of the ... of the team as it expands to accommodate the increased responsibilities. The Provider Hospital Reimbursement Analyst r will be primarily responsible… more
- J&J Family of Companies (Trenton, NJ)
- …+ Account Management and/or Reimbursement experience working in the hospital and/or provider office setting, building strong customer relationship. + ... to payer approval processes and business acumen. + Understanding of Medicare, Medicaid , and private payer initiatives affecting reimbursement of pharmaceutical… more
- J&J Family of Companies (New York, NY)
- …+ Account Management and/or Reimbursement experience working in the hospital and/or provider office setting, building strong customer relationship. + ... to payer approval processes and business acumen. + Understanding of Medicare, Medicaid , and private payer initiatives affecting reimbursement of pharmaceutical… more
- Genesis Healthcare (Monroe Township, NJ)
- …standards of care. *Manage the overall process and tracking of all Medicare/ Medicaid case-mix documents to assure appropriate reimbursement for services provided ... through the delivery of high-quality care and exceptional service. As a leading provider in the long-term care industry, we believe in fostering a collaborative,… more
- Guidehouse (New York, NY)
- …and third party payer accounts that are subject to pre-bill claim edits, hospital billing scrubber bill hold edits, and claim denials. **This position is 100% ... Integrity pre-bill edits and/or specific Revenue Integrity Hold Codes in the hospital billing scrubber. Tasks associated with this work include resolving standard… more
- Mount Sinai Health System (New York, NY)
- …quality of care and research. We have over 38,000 employees working together to provide billions of dollars in high-quality care each year for millions of patients. ... to keep entire communities healthy and out of the hospital . Mount Sinai Health Partners (MSHP) is the team...to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's… more
- Mount Sinai Health System (New York, NY)
- …organization and bridges the gap between clinical care and medical billing and reimbursement . This position will report to the Senior Director. This role will serve ... cycle, ensuring that patient care translates into accurate and timely reimbursement , safeguarding the financial well-being of the organization and contributing to… more
- Mount Sinai Health System (New York, NY)
- …quality of care and research. We have over 38,000 employees working together to provide billions of dollars in high-quality care each year for millions of patients. ... to keep entire communities healthy and out of the hospital . Mount Sinai Health Partners (MSHP) is the team...to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's… more
- Ascendis Pharma (Princeton, NJ)
- …deep understanding of US government pricing programs, and the pharmaceutical reimbursement landscape. Key Responsibilities + Lead the end-to-end government pricing ... and annual GP reports to CMS, VA/DoD, and state Medicaid agencies, and any programs requiring price reporting, per...any programs requiring price reporting, per legislative requirements + Provide government pricing impact assessments to aid in the… more
- Ascendis Pharma (Princeton, NJ)
- …managers (PBMs). This role requires expertise in contract management and reimbursement dynamics, coupled with strong leadership and analytical skills. The Director, ... and manage accruals for applicable vendor purchase orders. Assess and provide input to department's overall yearly budget. Requirements Key Responsibilities:… more
- Molina Healthcare (New York, NY)
- …modeling current and future contract rate proposals. + Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact of ... Business Intelligence tools (Medinsight, PowerBI), and Executive Dashboard. + Generate hospital performance analytics tools on a quarterly basis; develop reports on… more
- Mount Sinai Health System (New York, NY)
- …quality of care and research. We have over 38,000 employees working together to provide billions of dollars in high-quality care each year for millions of patients. ... to keep entire communities healthy and out of the hospital . Mount Sinai Health Partners (MSHP) is the team...to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's… more
- Allaire Rehab & Nursing (Freehold, NJ)
- …Federal and State regulations and reimbursement (Managed Care, Medicare, and Medicaid ). + Provide assistance with new Stakeholder orientation regarding the ... Spending Account + 401k available + Career advancement opportunities / tuition reimbursement + Complementary uniform + Friendly work environment + Referral bonus +… more
- Sanofi Group (New York, NY)
- …+ Maintain extensive knowledge of the Managed Care, GPOs, Specialty Pharmacy, State Medicaid and Veterans Affairs selling and reimbursement environment for their ... of belumosudil in their assigned geography, if approved. The IHM will provide on-label product information to designated key opinion leaders, health care… more
- Humana (Trenton, NJ)
- …for services rendered is complete, compliant and accurate to support optimal reimbursement . The Nurse Auditor 2 work assignments are varied and frequently require ... guidelines. Applies clinical experience when conducting chart reviews of hospital and facility billing. Understands department, segment, and organizational strategy… more
- Novo Nordisk (New York, NY)
- …of the local payer market including Medicare, Commercial and Medicaid benefit designs, Payer Coverage, Prescription Coverage Requirements, Step Therapy, ... strategies + May develop and utilize relationships with specialists, key hospital decision-makers, and other individuals who make or influence the purchasing,… more