- Sumitomo Pharma (Phoenix, AZ)
- **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
- Surgery Care Affiliates (Mesa, AZ)
- …Orientation: + Calculate co-pay, and estimated co-insurance due from patients per the individual payer contract per the individual payer contract and ... process of collecting over the counter payments/deductibles/copay/co-insurance. Knowledge of payer contracts including Medicare, Medicaid and other government… more
- HealthEdge Software Inc (Phoenix, AZ)
- …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
- HealthEdge Software Inc (Phoenix, AZ)
- …to grow with their organization over time-bringing disparate parts of a payer 's organization together for improved accuracy and insights. The Source platform offers ... Transformation features Medicare and Medicaid content coupled with flexible contract configuration capabilities for Commercial lines of business. Payment Integrity… more
- Prime Therapeutics (Phoenix, AZ)
- …Serves as facilitator and mentor to the clinical liaisons for assigned contract (s). Assists Account Managers with managing overall client relationship and driving ... program. Provides guidance, assistance and mentoring to assist the Account Manager staff in attaining goals. Requires communication across all departments and… more
- TERROS, Inc. (Phoenix, AZ)
- …audience level of knowledge. + Develop and maintains an understanding of current payer and NextGen configuration rules, contracts , and policies to provide ... medical policies, reimbursement policies, clinical editing policies, regulatory requirements, and contract details. This position reports to the Director of Revenue… more
- CenterWell (Phoenix, AZ)
- …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
- Option Care Health (Phoenix, AZ)
- …**Job Description:** **Job Responsibilities:** + Submits timely, accurate invoices to payer for products and services provided. Understands the terms and fee ... schedule for all contracts for which invoices are submitted. Correctly determines quantities...48 hours of receipt of payment. Notifies the Reimbursement Manager if there are overpayments and/or duplicate payments for… more
- BrightSpring Health Services (Scottsdale, AZ)
- …of new referrals. The Intake Coordinator will report to the General Manager and work in our Scottsdale branch. Amerita is an entrepreneurial-founded company ... the referral to a pharmacist. + Understands which insurance companies have contracts with Amerita + Communicates with other departments including Sales and pharmacy… more
- CVS Health (Phoenix, AZ)
- …convenient and affordable. Position Summary Aetna is recruiting for a Senior Manager , National Value Based Care (VBC) Development who will support innovative and ... executing enterprise wide initiatives. + Support contracting efforts including negotiating contract deal terms and support the development and implementation of… more