- 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 ... Qualifications** + Experience with Ohio Medicaid hospital reimbursement methodologies + Experience researching and resolving provider reimbursement… more
- Humana (Trenton, NJ)
- …The Provider Contracting Executive initiates, negotiates, and executes physician, hospital , and/or other provider contracts and agreements for an ... organization that provides health insurance. The Provider Contracting Executive works on problems of diverse scope and complexity ranging from moderate to… more
- Genesis Healthcare (Norristown, PA)
- …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
- AmeriHealth Caritas (Newtown Square, PA)
- …an informed and responsive approach to relationships with integrated delivery systems, hospital systems, physician groups, and other provider types. ; Working ... Fee Schedules, DRGs, EAPGs, Outlier Thresholds, and Chargemasters + Provider Network Optimization + Medicaid **Diversity, Equity,...you and your dependents on Day 1, 401(k) Tuition reimbursement and more. \#CO As a company, we support… more
- AmeriHealth Caritas (Philadelphia, PA)
- …+ Work with PBM to identify and resolve any operational issues. + Provide support and attend all pharmacy-related meetings and committees sponsored by the line ... participate on the plans' P&T Committee. + Generate necessary provider and member communications related to the pharmacy program....evaluate their effect on pharmacy contracts and services. + Provide on-site education and training for the line of… more
- Humana (Trenton, NJ)
- …to quality review the inpatient hospital claims for proper reimbursement , handle provider disputes in a result-oriented and metrics-driven environment. ... Fortune 100 Company values associate engagement & your well-being. We also provide excellent professional development & continued education. **Use your skills to… more
- Merck (North Wales, PA)
- …HHDDA, etc.),with focus on customer segments including health plans, Medicare, Medicaid , federal, pharmacy, hospital and Group Purchasing Organizations, among ... health economics outcomes research, and Organized Customer Access and Reimbursement teams to develop strategies to support current indications...on market access KPIs. + Support brand team and provide market access point of view during L3, QBR… more
- Genesis Healthcare (Huntingdon Valley, PA)
- Overview **ABOUT GENESIS** As the nation's leading provider of healthcare services from short-term to long-term and a wide variety of living options and professional ... you comfortable working cross-functionally with departments like **Admissions, Clinical Reimbursement , and Social Services** to maintain accurate and compliant… more