- CVS Health (Austin, TX)
- …Matter Expert support for questions related to recruitment initiatives, contracting , provider issues/resolutions, related systems and information contained. ... Vision vendors, in accordance with company standards to maintain and enhance provider networks while meeting and exceeding accessibility, quality and financial goals… more
- Gilead Sciences, Inc. (Santa Monica, CA)
- …CA headquarters. **Key Responsibilities** _Strategic Leadership_ + Partner with payer and provider leads to develop and execute contracting strategies across ... balance customer demand and long-term revenue potential + Track provider responses to various contracting options to...+ Extensive understanding of hematology / oncology clinical landscape, Medicare A & B, and the business of cell… more
- Lumeris (St. Louis, MO)
- …and/or managed care contracting . + Expert knowledge of provider contracting /negotiations, network development and configuration, standards for managed ... values its people and empowers you to make an impact. **Position:** Contracting Solutions Analytics Director **Position Summary:** Acts as an analytics Subject… more
- Ascendis Pharma (Princeton, NJ)
- …application process, managed market customers including private and public payers, national and regional health plans, state Medicaid, Medicare Part B and D, ... to join our team. Responsibilities will include implementing and executing contracting operations and tactics across all relevant customer segments for products… more
- Henry Ford Health System (Troy, MI)
- …Minimum of four (4) years in the Healthcare industry in Managed Care Contracting , Provider Relations, Provider Reimbursement or related professional ... Under supervision of Manager and / or Director, support the managed care contracting function by performing necessary financial analysis to evaluate payor (or health… more
- Providence (Irvine, CA)
- …New Mexico, Oregon, Texas, and Washington. As a mission-based, not-for-profit healthcare provider , our commitment to providing compassionate care to all lives on ... the best people, we must empower them.** **Providence is calling a Senior Manager Contracting who will:** + Be responsible for leading, or participating as a team… more
- Humana (Sacramento, CA)
- …understanding of how organization capabilities interrelate across segments and/or enterprise-wide. ** Regional VP of Health Services, Humana Medicare Advantage** ... and Medicare Advantage goals. **Primary Responsibilities:** Clinical Engagement & Provider Strategy: + Cultivate and maintain trusted relationships with CMOs and… more
- SSM Health (St. Louis, MO)
- …employers in every community it serves. This position is located on-site at our regional headquarters in St. Louis, Missouri and is not remote work eligible. To ... Angela Jones Executive Talent Partner ###@ssmhealth.com \#LI-Onsite **Job Summary:** The Regional Chief Financial Officer (CFO) is a key leadership team member… more
- Humana (Springfield, IL)
- …and procedures and Cardinal Care programmatic updates. + Coordinate periodic regional provider townhalls and/or trainings. + Attend Network Meetings/Conferences. ... & referrals). + Work with internal resources and systems (eg, claims, reimbursement, provider enrollment) to provide Exceptional Experience in all provider … more
- AbbVie (Mettawa, IL)
- …& financial impacts of pharmacy and/or medical contracting with National & Regional payers. + Provide insights into the Payer customer contracting ... of pharmaceutical businesses such as the Commercial Insurance channel, Medicare and Medicaid Channels. The role is a meld...help to ensure AbbVie has the appropriate pricing and contracting analytics for our current products, as well as… more
- CommonSpirit Health (Phoenix, AZ)
- …Ensures complex payer information and reports are analyzed and summarized to provide timely operationaland contracting recommendations for key internal leaders. ... the development, implementation and management of PSR system standards for contracting and payer relations on a divisional level. Accountabilities include:… more
- CVS Health (Jefferson City, MO)
- … systems or groups. + 3 to 5 years of experience with VBC, Commercial and Medicare contracting + 3 to 5 years of stakeholder management experience - experience ... with hospital systems and groups + Proven working knowledge of provider financial issues and competitor strategies, large/complex contracting options,… more
- Zelis (FL)
- …Network. Summary of responsibilities + Responsible for identifying, recruiting, negotiating, and contracting a dental provider network in a geographic area ... follow through that gains results. + Working knowledge of provider contracts and support providers on contracting ...network recruitment results + Industry knowledge of dental claims, provider relations, Medicare Advantage and other dental… more
- Rhythm Pharmaceuticals (Boston, MA)
- …payers. The NAD will develop and maintain relationships with national and regional Medicare payers, third-party administrators (TPAs), PBMs, employers and ... + Lead all market access and reimbursement strategies for assigned national and regional accounts within the commercial self-insured and Medicare Part D… more
- embecta (Parsippany, NJ)
- …Pricing & Contracts Sr. Analyst will support the analytics, operations and contracting functions within US Sales Channels and Canada, as required. Primary ... PBMs and payers for AOP/LRP and quarterly financial projections. Additional contracting responsibilities across the embecta North America commercial teams, including… more
- CommonSpirit Health (Rancho Cordova, CA)
- …Ensures complex payer information and reports are analyzed and summarized to provide timely operational and contracting recommendations for key internal leaders. ... the development, implementation and management of PSR system standards for contracting and payer relations. Accountabilities include: ensuring that managed care… more
- BD (Becton, Dickinson and Company) (Stuart, FL)
- …establishment, development and execution of the payor, managed care, and payer contracting medical policy initiatives in collaboration with BD's market access and ... to ensure optimal coverage and maximize reimbursement from Commercial, Medicaid and Medicare plans. The individual will also have direct supervision of the contract… more
- CareFirst (Baltimore, MD)
- …This position may request to extend that knowledge across other Commercial, Medicare and Medicaid plans as needed. This may also include assistance with ... will develop recommendations and prepare competitive analyses to include industry, regional , and internal benchmarks as needed. Research Federal, state and local… more
- Medtronic (Minneapolis, MN)
- …. + Established relationships with key decision-makers at commercial insurers, Medicaid, Medicare , and provider networks. Preferred: + MBA or master's degree ... act as a subject matter expert in payer relations, managed care contracting , and market access. In today's rapidly evolving healthcare environment, this position… more
- Corewell Health (Grand Rapids, MI)
- …plan-based risk adjustment operations, as well as developing innovative provider -based programs/solutions and other product-specific risk adjustment strategies as ... adjustment programs and an ability to partner effectively with provider groups to design and implement point of care...that can produce a high stress environment at times. Provide leadership planning, project coordination and management for the… more