- Stony Brook University (East Setauket, NY)
- …and denied accounts. + Collaborates on denials prevention initiatives. + Liaises with Managed Care Contracting and Insurance Company Provider Representatives ... Care Hospital Revenue Cycle or Patient Accounting Department resolving hospital Managed Care payment variances and/or denials. **Job Responsibilities may… more
- State of Minnesota (St. Paul, MN)
- **Working Title: Managed Care Contracting and Rates (MCCR) Director** **Job Class: Human Services Manager 4** **Agency: Human Services Dept** + **Job ... DHS Manager + **Division/Unit** : Health Care Administration / Managed Care Contracting and Rates + **Work Shift/Work Hours** : Day Shift / 8:00am -… more
- Elevance Health (Grand Prairie, TX)
- …or related field and a minimum of 3 years experience in broad-based analytical, managed care payor or provider environment as well as experience in statistical ... **Cost of Care /Provider Contracting Data Analyst Senior** **Location:**...competitive environment of providers to determine impact of proposed rates ; and projecting different cost of savings targets based… more
- WellSpan Health (York, PA)
- …regarding market payment rates and methods for various types of managed care payors: including Medicare, Medical Assistance, & Commercial managed ... for the System to ensure fair and adequate payment rates , operational terms that are acceptable and manageable, and...new hospital additions as applicable, in accordance with System Care Contracting Team. Includes all traditional medical… more
- Providence (Irvine, CA)
- …to the Providence Clinical Network. This role partners closely with Revenue Cycle, Managed Care , Finance, and Clinical leadership to address complex legal, ... and dispute resolution related to commercial, Medicare Advantage, and Medicaid managed care agreements. + Advise on reimbursement methodologies, payment… more
- Humana (Olympia, WA)
- … and network administration in a healthcare company + Experienced in negotiating managed care contracts with large physician groups, ancillary providers and ... community and help us put health first** The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider… more
- Point32Health (NH)
- …responsible management experience in a complex healthcare setting. Experience in managed care contracting and experience working collaboratively ... division needs and goals. Assess and monitor allied payment rates and recommend changes to methodology and rates...teams to achieve goals. + Strong working knowledge of managed care /risk contracting payment methodologies.… more
- Humana (Tallahassee, FL)
- …**Required Qualifications** + 2+ years of experience in negotiating or servicing managed care contracts + Understanding of contract terms, payment structures ... our caring community and help us put health first** The Provider Contracting Professional 2 initiates, negotiates, and executes physician, hospital, and/or other… more
- Humana (Hattiesburg, MS)
- …. He/she will have extensive business leadership experience, with several years in a managed care environment leading contracting for Medicare products. This ... healthcare leader for the position of Regional Vice President (RVP) Provider Contracting . The RVP will provide executive leadership to the Provider Contracting… more
- WellSpan Health (York, PA)
- …and denials. + Manages special projects as assigned by the Director of Managed Care . + Seeks and assists with identifying performance improvement initiatives ... party payors. Assists with maintenance of accurate expected payment rates in system applications and reference tools. **Duties and...within the Payor Contracting department to improve efficiency. + Maintains various contract… more
- Henry Ford Health System (Troy, MI)
- …EDUCATION/EXPERIENCE REQUIRED: + Bachelor's degree in Finance, Accounting, Business Administration, Managed Care Contracting , Reimbursement, or related ... Degree preferred. + Five to seven (5-7) years of experience in healthcare finance, managed care contracting , or reimbursement in a professional capacity… more
- St. Luke's Health System (Boise, ID)
- …remote from the states of Idaho, Oregon, Utah and Arizona only.** The Director, Managed Care Analytics is responsible for the creation and development of ... financial metrics, identifying trends, variances, and areas for improvement. + Analyze managed care contracts for financial performance, identifying areas for… more
- Health Care Service Corporation (Chicago, IL)
- …Automation and other divisions within the company.9.Provide leadership regarding negotiation of rates for traditional and managed care business. Conduct ... appropriate education/in-servicing is provided for providers. Education may pertain to managed care and areas where pertinent rulings/regulations could affect… more
- Elevance Health (Richmond, VA)
- …or related field and a minimum of 7 years of experience in broad-based analytical, managed care payor or provider environment as well as in depth experience in ... highest level of analytical support to the Cost of Care and/or Provider Contracting organizations. **How you...competitive environment of providers to determine impact of proposed rates and projects different cost of savings targets based… more
- Molina Healthcare (West Valley City, UT)
- …in the health care field including, but not limited to, provider's office, managed care organization, or other health care environment. * 3+ years ... in negotiating different provider contract types, ie physician, group and hospital contracting , etc. * Working familiarity with various managed healthcare… more
- Elevance Health (Atlanta, GA)
- …or related field; minimum of 5 years of experience in broad-based analytical, managed care payor or provider environment; considerable experience in statistical ... of Care Consultant** provides analytical support to the Cost of Care and/or Provider Contracting organizations. Focuses efforts on lowering claims costs,… more
- Highmark Health (Pittsburgh, PA)
- …**EXPERIENCE** **_Minimum:_** + 7 - 10 years' experience in managed care network development and provider relations/ contracting management in a healthcare ... to support contract negotiations. Conducts periodic review of provider contracting rates to ensure strategic focus is...and/or managed care environment + 7 - 10 years' experience in… more
- CommonSpirit Health (Rancho Cordova, CA)
- … rates and associated language, between physicians/hospitals and payers/networks for managed care contracting initiatives. Develop and approve financial ... is a remote position. The Senior Analyst, Payer Analytics & Economics performs managed care financial analysis, strategic pricing and payer contract modeling… more
- CommonSpirit Health (Phoenix, AZ)
- …reimbursement rates associated language, between physicians/hospitals and payers/networks for managed care contracting initiatives. + Review and ... and negotiation skills, a comprehensive understanding of healthcare reimbursement methodologies, managed care models, and regulatory requirements, and proven… more
- CommonSpirit Health (Englewood, CO)
- … rates and associated language, between physicians/hospitals and payers/networks for managed care contracting initiatives. Develop and approve financial ... Do you enjoy special projects on the more technical side of payer analytics and managed care ? The person in this role will need to be very proficent with SQL… more
