- Vanderbilt University Medical Center (Nashville, TN)
- …Resolves claim payment and operational issues occurring with managed care contracts. . KEY RESPONSIBILITIES * Coordinates payor specific operations ... in patient care , education, and research. **Organization:** Managed Care Ops **Job Summary:** JOB SUMMARY...Maintains database to track and manage operational issues by payor . * Identifies and discusses concerns or trends with… more
- KPH Healthcare Services, Inc. (Gouverneur, NY)
- …for maintaining all 340B contracts. In conjunction with the VP of Managed Care Contracting & Payor Relations /legal department, reviews and negotiates any ... new 340B contracts and renegotiation of existing transaction fees. + Responsible for evaluating all current and future contract pharmacy opportunities, including contract language, fee structure, data setup. + Responsible for analyzing capture data and… more
- Providence (Irvine, CA)
- …will be responsible for helping to lead our Acute, physician group, and ancillary entity relations with respect to managed care , and in the development, ... **Description** **THE ROLE** The Regional Contracting Director is the managed care leader for Providence Health & Services. The leader is responsible to develop… more
- Abbott (Livermore, CA)
- …plan covered lives. + Identify, develop, implement and maintain managed care relationships. + Closing and executing payor contracts, and building ... healthcare, business, or a related field. + 6+ years of relevant working experience in provider/ payor contracting in a managed care sales setting. + 5+ years… more
- Prime Healthcare (Denville, NJ)
- …Responsibilities The successful candidate will have substantial experience working with managed care plans on reimbursement issues. This may include ... disputed claims through mediation, arbitration, and litigation. This may also include payor relations efforts through joint operations committees or experience… more
- HCA Healthcare (Overland Park, KS)
- …this role:** + Serves as a subject matter expert in quality and value-based care programs such as MIPS, ACOs, and payor pay-for-performance contracts. Assists in ... Quality and Payor Initiatives) to achieve the organization's coordination of care goals, quality goals, and financial performance goals + Conducts in-person and… more
- Bristol Myers Squibb (Boston, MA)
- …Formulary Decision Makers and Influencers, etc.) within payer organizations and to managed care professionals to ensure access to effective treatment for ... with all policies and procedures + Build strategic, long-term relations with customers to be viewed as partners by...implementation of the clinical strategy for National and Regional Managed Care accounts, covering all books of… more
- Penn Medicine (Philadelphia, PA)
- …across inpatient and ambulatory financial services and professional experience to collaborate with Managed Care on rate negotiations and managing estimates for ... . This role partners significantly with VPs in AP Corporate Finance, VP of Managed Care , entity CFOs and other senior financial leaders across the enterprise.… more
- VIP Care (Tampa, FL)
- …and management experience in a healthcare environment + Primary care and value-based health care (ie, managed care ) experience is a plus + Experience in ... Our purpose is Better Health. Specializing in primary care for patients 65+ is our passion. What's...delivery environment as well as traditional Medicare and commercial payor environments. The Regional Practice Manager will partner with… more
- Henry Ford Health System (Troy, MI)
- …units. PRINCIPAL DUTIES AND RESPONSIBILITIES: 1. Under supervision of Director or Managed Care Contracting, works directly with Payors to negotiate contractual ... years in the healthcare industry in a professional capacity. + Knowledge of managed care organizations and integrated health systems. + Previous contracting,… more
- Covenant Health Inc. (Knoxville, TN)
- …and intermediaries, knowledge of third party reimbursement with working knowledge of Network/ Managed Care issues, and a thorough understanding of collection and ... pay period, Day shift Covenant Medical Group is Covenant Health's employed and managed medical practice organization, with more than 300 top Physicians and providers… more
- Sharp HealthCare (San Diego, CA)
- …End Time** Certified Revenue Cycle Representative (CRCR) - HFMA; Certified Specialist Managed Care (CSMC) - Healthcare Financial Management Association; HS ... PFS divisions of Community Care (CCD), Institutional Care (ICD), Managed Care (MC),...submitted in an accurate and timely fashion according to payor guidelines. Review explanation of benefits to ensure accurate… more
- Banner Health (Phoenix, AZ)
- …disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations , you'll find ... system, or health plan. Experience with hospital organized medical staff, managed care organizations, and continuous quality improvement activities preferred.… more
- AristaCare (Cranford, NJ)
- …in regards to accounts + Collections of all payors; Hospice, Medicare, Medicaid, MLTSS, Managed Care / Managed Medicare, Private + Check claim status for all ... the changes + Submit Billing Assistance form to Provider Relations for Medicaid claims + Submit cases to attorney...on a daily basis with doctor's office/vendors on residents' payor + Plan, organize, and implement, the facility's Business… more
- Gilead Sciences, Inc. (Hartford, CT)
- …with organization leadership (C-level stakeholders) focused on CAR T and patient care opportunities. + Create patient pathways across the ATC ecosystem through ... and senior stakeholders at individual ATCs to strengthen ATC relations and drive demand enablement, with a focus on...formulary decision makers focused on CAR T, on patient care opportunities, financial sustainability of CAR T therapy, and… more
- ChenMed (Miami, FL)
- …and value of services. + Work with various departments (operations, legal, and payor relations ) to ensure contracts meet operating, financial and legal ... cost, quality and value, and other clinical issues, especially within a managed care environment, required + Ability to establish and maintain positive and… more
- Banner Health (Mesa, AZ)
- …system, or health plan. Experience with hospital organized medical staff, managed care organizations, and continuous quality improvement activities preferred. ... Mesa, Arizona **Department Name:** Admin-Hosp **Work Shift:** Day **Job Category:** Clinical Care A network with resources for leaders with vision. We value and… more
- Banner Health (Scottsdale, AZ)
- …system, or health plan. Experience with hospital organized medical staff, managed care organizations, and continuous quality improvement activities preferred. ... Scottsdale, Arizona **Department Name:** Admin-Psych **Work Shift:** Day **Job Category:** Clinical Care At Banner Health, we set leaders up to succeed. We ensure… more
- Fresenius Medical Center (Mokena, IL)
- …or exceed budgets and key performance indicators. + Works closely with Managed Care resources to increase the payor mix and to retain commercial patients. + ... a defined area through effective leadership and management of quality patient care , customer relations , marketing and responsible fiscal management. Coordinates… more
- Atlantic Health System (Morristown, NJ)
- …Managers of PFS to maintain a thorough and up to date knowledge of payor reimbursement practices and procedures including Medicare & Medicaid regulations, as well as ... Managed Medicaid requirements * Troubleshoots any issues and escalates...hospital billing setting 3. Proven leader with excellent human relations skills 4. Embraces change by being able to… more