- BrightSpring Health Services (Englewood, CO)
- …Overview Key responsibilities include but are not limited to the management of the Payer Contract Administration and Payer Implementation functions as well ... payer related issues. Schedule:Monday - Friday, 8:30am-5pm - Remote We Offer * Medical, Dental & Vision Benefits...on payment rate and structure, and all aspects of contract language + Provides insight and knowledge in order… more
- Lundbeck (Kansas, IL)
- Regional Payer Account Director - Central Requisition ID: 7112 Location: Kansas City, IL, US Do you want to join a team where the mission is meaningful, the ... transform lives. Join us on our journey of growth! The territory for the Regional Payer Account Director Central includes the following states: TX, OK, KS, NE,… more
- IQVIA (New Providence, NJ)
- …and innovative technology across the healthcare ecosystem. **IQVIA's Healthcare Payer team** is currently seeking a seasoned and entrepreneurial-spirited ... technology, and strategic services for both regional and national healthcare payer clients.** This **individual contributor** role requires a savvy professional able… more
- ServiceNow, Inc. (Chicago, IL)
- …will do:** We are seeking a strategic and highly experienced Sr. Client Director to own and nurture C-suite relationships across multiple business lines, serving as ... growth through compelling, value-based storytelling focused on multi-year Customer Account Contract Value (CACV) expansion. + Develop and oversee account strategy… more
- United Therapeutics (CA)
- …business case development in the pharma/biotech industry + Proven national payer contract development, negotiation, and implementation + Current relationships ... access + Collaboration and Communication: Communicate regularly with the National Director of Payer Engagement, Market Access leadership, and cross-functional… more
- Mount Sinai Health System (New York, NY)
- …including admission and continued stay, and discharge reviews using CMS guidelines and payer contract terms. + Ensure timely and appropriate communication with ... ** Director Pre Appeals Management-HSO Appeals Management -Corporate 42nd Street-Full-Time-Days - Remote ** The Director , Pre Appeals Management is a strategic… more
- Takeda Pharmaceuticals (Boston, MA)
- …and process rebates and fees within ModelN FLEX revenue management system for both Payer and GPO contracts . Support data requests from US OBU Patient Value ... management and administration of assigned accounts. Ensures all pertinent contract attributes are properly translated into the correct ...bring all issues to a satisfactory resolution. + Gather Payer claim level data files, reconcile Payer … more
- Community Health Systems (Franklin, TN)
- … contracts , and other payers. This role includes analyzing contract compliance, identifying revenue opportunities, and communicating discrepancies to relevant ... review. + Collaborates with financial, clinical, and operational teams to address contract compliance issues and enhance payer relations. + Maintains knowledge… more
- St. Luke's Health System (Boise, ID)
- …development of detailed financial models, analyses and reports to support third party payer contract negotiations and optimization of the performance of existing ... **Overview** **Position can be remote from the states of Idaho, Oregon, Utah...in various departments on new or amended third party payer contract rates, terms, and conditions. Responsible… more
- Takeda Pharmaceuticals (Cambridge, MA)
- …and external healthcare payers. * Forecast VBA outcomes using internal datasets and payer -supplied data to support financial modeling and contract design. * ... to the best of my knowledge. **Job Description** The Director , Outcomes Research and Data Science (ORDS) is a...portfolio. * Assist in drafting VBA-specific sections of rebate contracts and support contract execution. * Work… more
- Takeda Pharmaceuticals (Boston, MA)
- …assessment (HTA; including the EU Joint Clinical Assessment [JCA]) and payer decision outcomes. Lead cross-functional integration and impact, resulting in ... ensuring that all evidence and access strategies are fully aligned with evolving payer , HTA, and policy needs globally + Pioneer and implement innovative digital,… more
- CommonSpirit Health (Phoenix, AZ)
- **Job Summary and Responsibilities** The System Director of IT Population Health Services Organization (PHSO) is a leader responsible for the strategic oversight, ... used for care coordination, risk stratification, quality improvement, and payer -provider integration, ensuring alignment with the organization's value-based care and… more
- Prime Healthcare (Chicago, IL)
- …+ Actively monitors and participates in the review and negotiation of third-party payer contracts . + Establishes and monitors standards for controlling the ... evaluate whether to in-source or outsource billing operations. The Director of Medical Group Revenue Cycle with our Prime...targets. + Performs ongoing trend analysis on third party payer payment levels to ensure that reimbursement is in… more
- Chiesi (CA)
- …+ Work collaboratively with Sales and Marketing to effectively maximize current payer scenarios. Negotiate and execute formulary contracts where applicable, ... This is what you will do The National Account Director (NAD) contributes to the company's success by being...individual Will play a critical role in executing corporate payer strategy by developing strategic relationships, along with securing… more
- AccentCare, Inc. (Roswell, GA)
- Overview Why You'll Love Being a Director of Personal Care Services at AccentCare Director of Personal Care / Personal Care Services Location: Roswell, GA ... Position: Job ID: Position Type: Full-Time Remote /Virtual Position: No Coverage Area: Find Your Passion and...Area: Find Your Passion and Purpose as a Clinical Director of Personal Care Services in Personal Care Services… more
- Somatus (Mclean, VA)
- …and mental well-being + Community engagement opportunities + And more! The Director of Population Health Operations will oversee execution of established clinical ... protocols and care management programs operationally. The Director will be responsible for the Profit & Loss (P&L) of one or more clients/line of business and ensure… more
- Genentech (South San Francisco, CA)
- **The Position** **The Opportunity** This Customer Segment Strategy - 340B, Director position is responsible for leading the development and implementation of access ... customer reactions and providing relevant talking points. + Synthesizes key contract performance insights across 340B customers to identify scalable insights for… more
- Community Health Systems (Antioch, TN)
- …revenue cycle, or contract management required + Familiarity with payer contracts and healthcare reimbursement methodologies preferred + Experience in ... analytical and problem-solving skills. + Proficient in understanding and interpreting payer contracts and reimbursement terms. + Effective communication and… more
- Community Health Systems (Franklin, TN)
- …ensuring timely resolution in compliance with government and managed care contract terms. This role requires effective communication with insurance payers, ... attendance. + Complies with all policies and standards. + This is a fully remote position **Qualifications** + HS Diploma or GED required + Associate Degree in… more
- University of Utah Health (Salt Lake City, UT)
- …management.** **- Analytical (data trends) and reporting.** **- Understanding of payer contracts and reimbursements.** _As a patient-focused organization, ... accounts. + Develops and manages escalation pathways for unresolved claims or payer disputes. + Implements process improvements for admissions, billing, third party … more