- Pairtu (San Francisco, CA)
- …company. ## **What Success Looks Like in 12 Months** - All provider credentialing and payer contracts are up-to-date and tracked in a clean, automated system. - ... need structure and predictability or 'need to be a manager ' this isn't for you. The upside? You'll level...payer enrollment, and ongoing compliance. - Keep every contract , license, and NPI file audit-ready. **2. Be the… more
- CommonSpirit Health (Phoenix, AZ)
- …determine profitability. + Provide training and oversight of the modeling of proposed/existing payer contracts negotiated by payer strategy and operations, ... a remote position that works predominately Pacific Coast time zone. As our System Manager , Payer , you will provide strategic leadership and expert oversight for… more
- Intermountain Health (Las Vegas, NV)
- … Contracting Manager is responsible for effective management of assigned payer contracts , including supporting contract negotiations and relationships. ... This leadership role manages all aspects of assigned payer contracts , including contract management, relationship management, dispute resolution, rate… more
- AbbVie (Mettawa, IL)
- …Tik Tok (https://www.tiktok.com/@abbvie) . Job Description As a key member of the Payer Contract Analytics team, this individual will be responsible for ... on deal/ no-deal decisions, inclusive of gross-to-net assessment of any proposed payer contract and economics from the payer perspective (as needed),… more
- Cognizant (Mason, OH)
- …margin. Cognizant Technology Solutions is currently seeking a highly skilled **Healthcare Payer Client Relationship Manager ** (Associate Director) who will be ... accounts, leading the day-to-day activities and P&L of these accounts. The Healthcare Payer CRM works with delivery teams to enhance backlog, optimizing the resource… more
- Hartford HealthCare (Hartford, CT)
- …programs and other common practices across the system. *_Position Summary:_* Reporting directly to the Manager of Payer Contract Analytics, the Sr. Payer ... contracting initiatives. *_Working Relationships:_* *This Job Reports To (Job Title):* Manager of Payer Contract Analytics...*This Job Reports To (Job Title):* Manager of Payer Contract Analytics *Internal:*Will engage with PFS,… more
- BrightSpring Health Services (Nashville, TN)
- …in a fast -paced, collaborative and team-based objectives . + Ability to understand payer contracts and translate information into payer setup for multiple ... Our Company BrightSpring Health Services Overview The Revenue Cycle Support/Project Manager is responsible for accurate payer and contractual allowance setup… more
- AbbVie (Mettawa, IL)
- …as future pipeline products. Key Job Responsibilities Responsible for working with hiring manager to perform payer contract analysis, communicate results/ ... . Job Description As a key member of the Payer Contract Analytics team within APEX, the...area and channel of business + Measure performance of contracts by retrospectively evaluating performance of contracts … more
- Fairview Health Services (Minneapolis, MN)
- …payment methodologies. + Reviews charge levels against third party payer contracts , summarizes findings and communicates results to manager and the revenue ... proposal evaluations, claims payment accuracy reconciliation and pharmacy payer contract liaison activities. The Financial Analyst...payers. + Support manager in tracking top contracts , top lines of business and payer … more
- Albany Medical Center (Albany, NY)
- … terms. The Director is skilled at drafting, analyzing, and negotiating complex payer contracts . The Director develops contract proposals and leads ... and builds systems and standardized processes to facilitate multi-stakeholder collaboration on payer contracts to achieve best negotiation outcomes. + Develops… more
- Organon & Co. (Dover, DE)
- **Job Description** **The Position** The Regional Payer Account Director (RPAD) reports directly to the Executive Director, Regional Payer Accounts. The RPAD ... relationships through productive business relationships as well as profitable contracts and programs. The primary customer/account responsibilities include key… more
- Fallon Health (Worcester, MA)
- …in a managed care payer preferred. * One year experience as a case manager in a payer or facility setting highly preferred. * Relevant experience may include ... **Overview** **This is 3 months temporary contract position for a Prior Authorization RN.** **About...Keeps records and submits reports as assigned by the Manager * Refers high-risk cases to the appropriate FH… more
- University of Rochester (Rochester, NY)
- …support and direction to the team. + Trains staff to understand and adhere to contract language by payer for appropriate reimbursement to the hospital and ensure ... account notes and adjustments. + Attends monthly team meetings with the Outpatient Manager and appropriate payer representatives. + Runs, distributes and ensures… more
- Robert Half Accountemps (Taunton, MA)
- …high balance accounts and report any account activity concerns to the Billing Manager . * Stay informed about payer specifications and independently research ... Billing Clerk to join our team on a long-term contract basis in Taunton, Massachusetts. In this role, you...claims reconciliations and resolve issues independently. * Knowledge of payer specifications and timely filing requirements for claims. *… 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 ... bring all issues to a satisfactory resolution. + Gather Payer claim level data files, reconcile Payer ...experience in the pharmaceutical industry required. + ModelN/Flex Revenue Manager experience in contract implementation and maintenance… more
- Regeneron Pharmaceuticals (Sleepy Hollow, NY)
- …supports the redline process to commit agreed upon deal terms to executed contracts . **A typical day may include:** ** Contract Strategy Management and ... The Contract Strategy team has responsibility for developing contracting...own specific accounts and business segments (either IDNs, GPOs, Payer ) for the purpose of strategy development. The Director,… 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
- Mount Sinai Health System (New York, NY)
- …Experian Contract Manager Tool to determine financial performance. + Model Payer Proposals in Experian Contract Manager Tool. + Reconcile budgeted ... within MSHP is responsible for the negotiation, implementation and contract compliance related to Facility Contracts for...Own the development and execution of pricing strategies in payer contract negotiations. + Mentor analysts in… more
- Guthrie (Sayre, PA)
- Summary The Denial, Appeal, and Audit Manager is responsible for the oversight and management of all payer denials, appeals, and audit processes within the ... of claim denials, effective appeal strategies, and proactive audit response. The manager leads a team of specialists, coordinates with internal departments, and… more
- Ascendis Pharma (Princeton, NJ)
- …specialty pharmacy, and/or GPO agreements (eg, rebate, discount, and data sharing contracts ). + Operational Execution: Oversee contract set-up, terms validation, ... their skills. Position Summary: We are seeking a highly motivated Senior Manager to support our Contracting Operations function within the Market Access… more
