- 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
- 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
- AbbVie (Mettawa, IL)
- …for securing patient access to our portfolio of products across all payer and distribution channels including Commercial health plans, PBMs, Medicare, ... and deliver innovative medicines and solutions that solve serious health issues today and address the medical challenges of...and GPO's (Oncology and Eye Care). The purpose of Payer Marketing is to provide overarching direction and leadership… more
- Takeda Pharmaceuticals (Boston, MA)
- …to represent payer and channel customer segment + Consider full enterprise when recommending strategies + Partner with New Product Planning and Business ... Plasma-Derived Therapies BUs) + Responsible for value story development, payer /PBM contracting strategy, pricing, specialty pharmacy and distribution plans,… 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
- 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
- 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
- LA Care Health Plan (Los Angeles, CA)
- …$105,267.00 (Min.) - $139,478.00 (Mid.) - $156,000.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created by the state of ... County residents. We are the nation's largest publicly operated health plan . Serving more than 2 million...Required: At least 5-7 years of experience as an Enterprise Applications engineer/administrator Minimum 5 years of experience technical… more
- Tufts Medicine (Burlington, MA)
- …and objectives of the department to align with the organization's business plan . 10. Manages, communicates and pursues enterprise Accounts Receivable targets. ... goals of the revenue cycle and the overall financial performance of the enterprise . 12. Partners with Payer Relations/Contracting communicating Payer … more
- Children's Hospital Boston (Boston, MA)
- …proposed pricing strategy recommendations. + Monitor and value impact of Payer 's payment policies and provide guidance to adjust contracting reimbursement to ... the managed care contracts into EPIC and Experian. + Track changes in Payer rates, requirements and applicable regulation and the impact on charges and requirements… more
- Abbott (Plano, TX)
- …other pharma experience. + Demonstrated knowledge of US and global healthcare payer systems, including expertise in health care financing, reimbursement policies ... you can grow the career you dream of. + Health care and well-being programs including medical, dental, vision,...qualify for FREE coverage in our HIP PPO medical plan . Free coverage applies in the next calendar year.… more
- Trinity Health (Livonia, MI)
- …provides management oversight for ensuring that the clinical documentation across the enterprise supports a complete and accurate record of the patient care ... and post-acute care services. This position works closely with Regional Health Ministries Documentation Improvement Leads, Revenue and Charge Capture Leads/Liaisons,… more