• Associate Director, US Pharma Payer

    Merck (North Wales, PA)
    …to provide solutions to meet them. The Associate Director, US Pharma Payer Marketing, Immun, is responsible for developing market access strategies and solutions ... individual will collaborate across functions in the development of payer customer segment strategies, value evidence plans, and forecasts....with Hybrid work model (3 days per week onsite); Remote will be considered with expectations of travel (up… more
    Merck (11/19/24)
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  • Revenue Cycle Clinical Advisor

    Mayo Clinic (Rochester, MN)
    **Why Mayo Clinic** Mayo Clinic is top-ranked in more specialties than any other care provider according to US News & World Report. As we work together to put the ... in competitive compensation and comprehensive benefit plans (https://jobs.mayoclinic.org/benefits/) - to take care of you and your family, now and in the future. And… more
    Mayo Clinic (11/21/24)
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  • Sales Senior Advisor - Evernorth Health…

    The Cigna Group (St. Louis, MO)
    …clinical solutions, as well as an understanding of client benefit and health care needs. It requires the ability to cultivate and leverage channel relationships to ... leaders. + Collaborate internally across all Evernorth business lines, including Care Coordination, eviCore Medical Benefit Management, Express Scripts PBM, and… more
    The Cigna Group (11/26/24)
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  • Physician Advisor Denials Management

    CommonSpirit Health (Sacramento, CA)
    …our hospitals and out in the community. **Responsibilities** **This is a remote position.** **Summary** The Utilization Management Physician Advisor II conducts ... Initiatives (CHI) and Dignity Health. With more than 700 care sites across the US from clinics and hospitals...and health information personnel + Conducts peer-to-peer reviews with payer medical directors to discuss and advocate for the… more
    CommonSpirit Health (09/20/24)
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  • Physician Advisor

    Health First (Melbourne, FL)
    …to enhance patient care plans and address quality issues. 4. Facilitate Payer Interactions: Act as a liaison with payers to streamline approvals and address ... *POSITION SUMMARY:* The Physician Advisor is a key member of the Health...Health First Hospital Division, responsible for ensuring high-quality patient care and efficient use of healthcare services. This role… more
    Health First (11/25/24)
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  • Utilization Mgmt ED RN - Case Management…

    Stanford Health Care (Palo Alto, CA)
    …Program, special programs, educational assistance, and adoption assistance! **This is a remote Stanford Health Care job.** **A Brief Overview** The Utilization ... to ensure clinically sound and persuasive appeals. 5. Physician Advisor Collaboration: Engage with physician advisors on a regular...and cost-effective care delivery. **Locations** Stanford Health Care ( Remote ) **What you will do** +… more
    Stanford Health Care (09/21/24)
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  • RN Care Coordinator - ECCM (Pittsburgh…

    Highmark Health (Harrisburg, PA)
    …Collaboratively formulates plans of action for denial trends with the care coordination teams, performance improvement teams, physicians/physician advisor and ... **Company :** Endorsed **Job Description :** **JOB SUMMARY** ** Remote /Hybrid - In home visits in and around...area.** This job is proficient in the coordination of care and manages coordination of care in… more
    Highmark Health (09/28/24)
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  • Care Coordinator, Utilization Management

    Hackensack Meridian Health (Neptune, NJ)
    …if required documentation is present. + Obtains appropriate records as required by payer agencies and initiates physician advisor 's review as necessary for ... and serve as a leader of positive change. The ** Care Management, Care Coordinator, Utilization Management** is...New Jersey regulations for Nursing **.** **This is a remote , night shift position. The schedule for this role… more
    Hackensack Meridian Health (11/15/24)
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  • RN Case Manager: University Hospital ( Care

    University of Michigan (Ann Arbor, MI)
    RN CASE MANAGER: University Hospital ( Care Management) Apply Now **Job Summary** The RN Case Manager assesses, develops, implements, coordinates and monitors a ... comprehensive plan of care for each patient/family in collaboration with the physician,...admission; review every 3 days or as requested by payer + Determine patient classification with provider and ensure… more
    University of Michigan (11/09/24)
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  • RN Charge Auditor

    Ascension Health (Glendale, WI)
    …education, experience, location, and qualifications. Connect with your Talent Advisor for additional specifics._ **Responsibilities** Coordinate payer denials ... some flexibility)** + **Hospital: AW Glendale Corporate Office** + **Location: Remote ** **RN License REQUIRED.** **Candidate MUST reside in Wisconsin.** **Benefits**… more
    Ascension Health (10/17/24)
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  • Director Clinical and DRG Denials

    Kaleida Health (Buffalo, NY)
    …promotes a positive, team-oriented work environment. Develops relationships and influences payer policies and procedures as well as facilitating strong working ... relationships between HIM, Clinical Documentation, UR, Physician Advisor operations, PFS, Contracting, and hospital departments and leadership to promote effective… more
    Kaleida Health (11/25/24)
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  • Director, Outcomes Research

    Merck (Rahway, NJ)
    …consistent with marketing strategies in key countries. This position will focus on Primary Care / Hospital & Specialty Care / Primary Care . Specific roles ... input into clinical and market development programs. Bring strong payer and HTA/reimbursement focus into the Value & Implementation...and evaluate health programs leveraging different parts of health care systems that can enhance value and use of… more
    Merck (11/19/24)
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  • RN Case Manager- Case Management

    Health First (Viera, FL)
    …9. Works collaboratively and maintains active communication with physicians, nursing, physician advisor , and other members of the interdisciplinary care team to ... clinical skills in the assessment, planning, intervention and evaluation of patient care in accordance with Federal Conditions of Participation, State of Florida… more
    Health First (10/17/24)
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  • AVP Revenue Integrity / Middle Cycle

    Ascension Health (Batavia, IL)
    …enterprise-wide strategic pricing analysis to support contract negotiations for all managed care payer contracting initiatives. + Ensures compliance with federal ... you join a diverse team united by our mission; to provide compassionate, personalized care to all - especially to those most in need. **Benefits** Paid time off… more
    Ascension Health (11/16/24)
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  • Associate Principal Scientist (Associate Director)…

    Merck (Rahway, NJ)
    …within and across work groups to achieve results. + Knowledge of evolving payer and reimbursement environment: Understanding of US Value Assessments and other key ... more detail, please contact your HRBP or Talent Acquisition Advisor . #EligibleforERP \#EBRG Current Employees apply HERE (https://wd5.myworkday.com/msd/d/task/1422$6687.htmld) Current… more
    Merck (11/15/24)
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  • Analyst-Charge

    Ascension Health (Austin, TX)
    …M-F (some weekends)** + **Hospital: Seton Family of Hospitals** + **Location: Remote ** **Benefits** Paid time off (PTO) Various health insurance options & wellness ... education, experience, location, and qualifications. Connect with your Talent Advisor for additional specifics._ **Responsibilities** Review, analyze and coordinate… more
    Ascension Health (11/26/24)
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  • Charge Audit Representative

    Ascension Health (Jacksonville, FL)
    …**Department:** Revenue Cycle Management + **Schedule:** Monday - Friday 7:30a-4pm Remote . + **Hospital:** Ascension St. Vincent's Southside Hospital + **Location:** ... education, experience, location, and qualifications. Connect with your Talent Advisor for additional specifics._ **Responsibilities** Audit patient registration documentation… more
    Ascension Health (11/23/24)
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  • Internal Audit Strategy & Technology Enablement…

    Robert Half (Houston, TX)
    …curious individuals for whom learning is a passion. We lean into our mission: We Care . We Collaborate. We Deliver. At every level, we champion leaders who live our ... complexities of the healthcare technology environment in healthcare provider , payer , pharmaceutical, and/or life sciences organizations. + Defining, designing,… more
    Robert Half (10/17/24)
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