- Novo Nordisk Inc. (Plainsboro, NJ)
- …Collaborates with internal and external stakeholders to leverage and implement knowledge of reimbursement , managed care and healthcare policy to develop ... insights to all relevant partners External relationships include interactions with key managed markets payers (potentially including but not limited to payers, PBMs,… more
- e CancerCare (Nashville, TN)
- …in reports, which includes determining the impact of adjustments to managed care reimbursement terms and/or contract compliance, along with rate modeling ... reimbursement terms in a multi-functional approach to Managed Care strategies. . Assume other projects...skills are necessary. . Years of Experience: 1-2 in Managed Care + contract negotiating… more
- Sharp HealthCare (San Diego, CA)
- …high accuracy in transactions, write-offs, refunds, issue resolution, etc.) + Knowledge of Managed Care Contract Reimbursement , Government ... base of current regulations of affiliated payors through coordination with Contract Reimbursement Specialist.Centralizing and reviewing all denial material… more
- UNC Health Care (Morrisville, NC)
- …the unique communities we serve. **Job Summary:** The System Executive Director - Managed Care position is responsible for planning, directing and coordinating ... all Managed Care operations. This position establishes and...broad understanding of principles including financial planning and analysis, reimbursement , contract negotiations and problem solving. *Maintains… more
- CommonSpirit Health (Englewood, CO)
- …Manager, Payer Analytics and Economics is accountable for the managed care financial analysis, strategic pricing and payer contract modeling activities for ... maximizing reimbursement and market share. Develops new managed care products with external payers that...Monitor contract financial performance. Analyze and publish managed care performance statements and determine profitability.… more
- Banner Health (AZ)
- …depth understanding of Commercial, AHCCCS and CMS reimbursement methodologies. Assignments in Managed Care require strong contract writing skills as well ... by offering remote and hybrid work settings. As a Managed Care Contract Consultant with...Care . 4. Understand physician, facility and ancillary service contract reimbursement methodologies for Medicare, Medicaid, Exchange… more
- Abbott (Livermore, CA)
- …Our 114,000 colleagues serve people in more than 160 countries. **Job Title ** ** Managed Care Specialist, HF** **Working at Abbott** At Abbott, you can do ... their health and get on with their lives. The ** Managed Care Sales Specialist** is responsible for...subordinates. + Advanced knowledge of provider contracts and health care reimbursement and ability to negotiate effectively… more
- McLaren Health Care (Auburn Hills, MI)
- We are looking for a Managed Care Coordinator to join us in leading our organization forward. McLaren Health Care is one of Michigan's fastest growing health ... Summary:** Responsible for implementing, operationalizing and administration of third-party payor/ Managed Care agreements within all market segments for… more
- AdventHealth (Altamonte Springs, FL)
- …value you'll bring to the team:** . Provide documentation to internal departments on managed care contract requirements and changes including but not limited ... to attend to meetings** **The role you'll contribute:** The Managed Care Coordinator is a responsible member...and support staff in order to obtain the optimum reimbursement , decrease operational overhead, and maximize patient benefits. **The… more
- WMCHealth (Valhalla, NY)
- …existing payers and first time payers. + Responsible for review of managed care contracts, including redlining of contract language and rate sheets for the ... Manager, Managed Care Company: NorthEast Provider Solutions...N/A Other: Special Requirements: + Thorough knowledge of various reimbursement methodologies, such as MSDRG, APR DRG, CPT-4, HCPCS,… more
- Hartford HealthCare (Wethersfield, CT)
- …the Sr. Payer Analyst develops a modeling process for negotiated rate changes with Managed Care payors for hospital services. Develops payment related tools such ... **Organization:** **Hartford HealthCare Corp.* **Title:** *Senior Payer Analyst / Managed Care Contracting* **Location:** *Connecticut-Wethersfield-1290 Silas Deane… more
- Northwell Health (New Hyde Park, NY)
- …+ Works with management to interpret contract language as it relates to managed care reimbursement rates and contractual provisions. + Assists senior ... **Req Number** 124332 Job Description Develops managed care contract proposals for health system entities. Addresses operational issues and ensures … more
- Prime Healthcare (Lynwood, CA)
- …https://www.eeoc.gov/sites/default/files/2022-10/EEOC\_KnowYourRights\_screen\_reader\_10\_20.pdf Responsibilities The Senior Managed Care Biller/Collector ... with the specific payer guidelines, policies, procedures, and compliance regulations for managed care . This includes maintaining the deficiency lists used to… more
- BayCare Health System (Clearwater, FL)
- …during the contract negotiation process. + Serves as Primary Contact for contract / managed care payer claims and operational issues resolution for ... of trust, dignity, respect, responsibility and clinical excellence. **Responsibilities:** + The Managed Care Financial Analyst Sr. performs financial analyses of… more
- UCLA Health (Los Angeles, CA)
- …Bachelor's degree preferred * Experience with a healthcare provider organization * Advanced managed care contract negotiation skills, preferably within a ... medical group, or health plan environment * Understanding of the Southern California managed care marketplace * Knowledge of hospital and professional … more
- Omnicell, Inc. (Grapevine, TX)
- …Client Solutions, Information Technology, Accounting, and Finance Teams to ensure all managed pharmacies are performing at the highest level. Essential functions + ... networks as possible to ensure prescription retention. + Negotiates to keep reimbursement rates reasonable. + Works closely with the Corporate Controller regarding … more
- Sharp HealthCare (San Diego, CA)
- …of payor issues. **Required Qualifications** + Bachelor's Degree + 5 Years experience with managed care contract negotiation and/or interpretation. + 3 Years ... + Department competencyResearching and interpreting legal language for application to contract reimbursement and billing and educates staff as… more
- Elevance Health (St. Louis, MO)
- …or related field; minimum of 5 years experience in broad-based analytical, managed care payor or provider environment; considerable experience in statistical ... check, or ask you for payment as part of consideration for employment. **Provider Contract /Cost-of- Care Consultant** + Job Family: RDA > Health Economics & Cost… more
- Commonwealth Care Alliance (Farmington Hills, MI)
- …- 3-5 years of experience - Specific background in provider contracting in a health care or managed care setting required. - Exceptional provider partnership ... internal and external groups. - Particular expertise in Medicare and Medicaid health care reimbursement methodologies. - Knowledge of ICD-10 and CPT codes… more
- Northern Light Health (Brewer, ME)
- …all its subsidiary member organizations. Reporting to the Manager of Payer Strategy & Managed Care Operations (PSMCO), the Contract Analyst will collaborate ... management. Responsibilities: * Monitors contract performance and payer compliance with Managed Care contracts. * Assists in providing gap analysis between… more
