- Sumitomo Pharma (Oklahoma City, OK)
- **Title: Sr. Manager , Medicaid Contract Administration** **Location: Remote/occasional onsite (if local to MA). Flexible work/life balance.** Sumitomo Pharma ... motivated, and experienced individual for the position of **Sr. Manager , Medicaid Contract Administration.** The Sr. ...of the life science industry specific to the Medicaid payer landscape. The decisions made in this position affect… more
- HealthEdge Software Inc (Oklahoma City, OK)
- …door to new value-based reimbursement models, benefits plans and provider contracts . The complete suite of solutions fromHealthEdgedelivers a digital foundation for ... payers specifically designed to fuel a digital transformation, reduce costs, and improve both clinical outcomes and the member experience. **Your impact** **:** + Manage and standardize programs to meet the client's release/deployment and quality criteria. +… more
- KPH Healthcare Services, Inc. (Oklahoma City, OK)
- …contractual relationships and ensures that clients are admitted according to contract provisions. + Maintains comprehensive working knowledge of community resources ... personnel and referral sources + Consults with the case manager or supervisor for any of the following: +...pending unresolved coverage issues + Obtaining initial authorization from payer sources to begin services + Obtains authorization from… more
- CenterWell (Oklahoma City, OK)
- …support accreditation requirements + Oversight of home infusion reporting for third party payer contracts + Monitor the following key functions: + Program ... vendors and as necessary + Reviews and updates vendor contracts with procurement as necessary + Ensure that the...of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing… more
- Evolent Health (Oklahoma City, OK)
- …to assigned health plan. + Acts as Subject Matter Expert on the contract for their assigned health plan, particularly billing requirements and reviews pricing to ... sure that the claim is billed to the proper payer source, in the proper billing format, with the...contacts with outside individuals on billing issues. + Informs Manager of problem accounts promptly. + Performs schedules hours,… more