- 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 Medicare (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... Pricer Business and System Support team responsible for administering complex Medicare provider reimbursement methodologies. The business needs of the team… more
- J&J Family of Companies (Titusville, 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
- Cardinal Health (Trenton, NJ)
- …Managed Care oversees the interactions that take place between payer and provider (s) to ensure optimal reimbursement including managed care contracting, ... Functions:** + Responsible for documenting and tracking all credentialing, re-credentialing, provider enrollment, and hospital privileging activities within the… 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
- Teva Pharmaceuticals (New York, NY)
- …possess a strong analytical acumen, a deep understanding of the New York Medicaid and hospital outpatient landscape and demonstrated success navigating complex ... influencers, and prescriber networks. + Leverage deep knowledge of the NY Medicaid system and broader payer systems to support access and overcome barriers… more
- Weill Cornell Medical College (New York, NY)
- …CPT, ICD-9, and ICD-10 coding. + Working knowledge of third party payor reimbursement - Medicare, Medicaid , Managed Care and commercial insurance. **Licenses and ... practices serve communities throughout New York City, and our faculty provide comprehensive care at NewYork-Presbyterian Hospital /Weill Cornell Medical Center,… 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
- BAYADA Home Health Care (Pennsauken, NJ)
- …Perform an initial screening/verification of benefits according to Medicare, Medicaid , and third-party payor guidelines, coordinate equipment with contracted ... to determine suitability for admission to Hospice care according to Medicare, Medicaid , and third-party payer guidelines. + Maintain discretion, as the position… more
- Humana (Trenton, NJ)
- …coding auditor to review inpatient hospital claims for proper reimbursement , handle provider disputes in a result-oriented and metrics-driven environment. ... Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims… 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
- Gentiva (Trevose, PA)
- …hospice agency promptly if unable to complete F2F visits as scheduled. + May provide F2F coverage for multiple provider numbers with approval. **About You** ... physicians, interdisciplinary group (IDG) members, patients, caregivers, and families. + Provide clinical recommendations to the IDG based on F2F assessment… 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
- Genesis Healthcare (Wyncote, PA)
- …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, ... you comfortable working cross-functionally with departments like Admissions, Clinical Reimbursement , and Social Services to maintain accurate and compliant patient… 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