- Jazz Pharmaceuticals (Palo Alto, CA)
- …of brand strategy. The AD is responsible for the implementation of the payer value proposition and promotional/non-personal tools and tactics for use with third ... addition, this individual will work cross-functionally with various field teams including Payer Account teams, Field Access and Reimbursement teams, and Field Sales… more
- Christus Health (Irving, TX)
- …as a patient advocate, providing proactive outreach to CHRISTUS Health value-based payer patients. The RN Navigator makes recommendations to primary care providers ... of Leaders. Stays abreast of current CMS and other payer guidelines for Home Health services. Receives and evaluates...up for patient needs. Based on CMS or other payer guidelines, patient assessment, and case conferences, makes recommendation… more
- UNC Health (Chapel Hill, NC)
- …CPT codes in accordance with the Official Coding Guidelines, and third party payer , state and federal regulations. 10. Identifies cases for CDI Physician Advisor ... intervention and coordinates the CDI Physician Advisor scheduling, reviews and educational opportunities with residents, faculty, Advanced Practice Professionals (APP). 11. Collects the statistics from the reviews and maintains accurate records of review… more
- Aveanna Healthcare LLC (Huntsville, AL)
- …with cost-efficiency Prepare case reviews and help with accreditation and payer compliance Benefits Offerings: 401(k) with company match Health, dental, vision, ... life, and pet insurance Mileage reimbursement and cell phone allowance Generous PTO, sick time, and paid holidays Inclusion Day to celebrate what matters to you Float Day for extra flexibility and balance Up to 8 Hours of Paid Volunteer time yearly No-Cost… more
- Pairtu (San Francisco, CA)
- …We're looking for a senior, hands-on operator who can work across credentialing, payer contracting, provider onboarding, and day-to-day ops while keeping a sharp eye ... on patient experience and quality. You'll own the connective tissue between our advocates, payers, and leadership team - ensuring no patient falls through the cracks, no credentialing deadline slips, and no operational ball is dropped. This is **not** a… more
- PedIM Healthcare (Crystal River, FL)
- …work independently and meet deadlines. Familiarity with insurance claim submission and payer requirements. Schedule This is NOT a remote position. This position ... reports to the Billing Manager. The schedule is M-F, 8:30AM-5:00PM. Apply today Apply at www.pedimhealthcare.com (click on Our People, click on Careers) Final applicant must undergo a background screen EOE PM20 Compensation details: 16-18 Hourly Wage… more
- Mount Sinai Health System (New York, NY)
- …critical metric for care excellence and primary care success) Focused on all payer classes, with deeper focus on patients who have Medicare and Commercial insuran ... This SMD will report to the CMO, Population Health and Clinically Integrated Network. The SMD will partner with the MSHP analytics team, Digital and Technology Partners (DTP, ie IT) Epic EMR team to drive targeted quality and patientengagement performance most… more
- Cayuga Health System (Ithaca, NY)
- …Examples may include but are not limited to value-based purchasing ( payer ) metrics, infection control rates, and evidence-based clinical performance metrics. Report ... regularly to the Medical Executive Committee and Administration on the progress towards the strategic and operational goals as determined by Administration and Medical Executive Committee. Identify quality metrics, implement strategies for improvement, and… more
- Catholic Health System (Buffalo, NY)
- …Accept all patients for medical management, treatment and surgery regardless of payer status and/or ability to pay. Provide coverage for emergency problems to ... maintain continuity of patient care. Perform surgery as indicated. Manage adjuvant inpatient and outpatient therapies for patients as needed. Perform inpatient coverage, rounding, consultations, and care for assigned patients as scheduled. Participate in… more
- Trinity Health (Albany, NY)
- …All-Inclusive Care for the Elderly) across the country are delivering this unique payer /provider healthcare model to enable seniors to remain in the community and ... avoid/delay nursing home placement. Imagine, primary care where you: See just 3-5 patients a day as a full-time primary care provider (you read that correctly, its not a typo!) Spend 1 hour with your patients, or more! You drive your schedule! Work Monday thru… more
- Hartford HealthCare (Hartford, CT)
- …practices across the system. *_Position Summary:_* Reporting directly to the Manager of Payer Contract Analytics, the Sr. Payer Analyst is responsible for ... analytics with a focus on hospital and ancillary. Reviews and monitors contract/ payer performance including payer parity. Compares expected reimbursement data to… more
- BGB Group (New York, NY)
- EVP, Market Access and Payer Marketing at BGB Group (View all jobs) (http://www.bgbgroup.com/careers.html) New York, NY BGB Group EVP, Market Access & Payer ... of services, including traditional pharmaceutical advertising, promotional medical education, payer marketing, and consulting services. Known for excellence and… more
- Waystar (Atlanta, GA)
- **ABOUT THIS POSITION** The Payer Relations Specialist is responsible for initiatives to identify and build contractual relationships with payers for direct data ... connections with those payers. As a key member of the Waystar payer relations team, the Payer Relations Specialist will drive new value for Waystar's clients by… more
- CGI Technologies and Solutions, Inc. (Canton, MA)
- **Senior Payer Process Assessment & BPM Lead** **Category:** Business Analysis (functional and technical) **Main location:** United States, Massachusetts, Canton ... are seeking a Healthcare Subject Matter Expert (SME) - Payer who brings deep expertise in payer -domain...- Payer who brings deep expertise in payer -domain operations and processes. This individual will play a… more
- Novant Health (NC)
- …to ensure a safe, remarkable patient experience. What You'll Do The Director of Payer Strategy will lead payer accountability and manage contract performance and ... . Leadership and Management: Provide strategic direction and leadership to the payer strategy and defense audit team, ensuring alignment with the overall goals… more
- CommonSpirit Health (Englewood, CO)
- …Central time zone. 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 ... side of our contract modeling system. The Senior Analyst, Payer Economics performs complex managed care payer ...Analyst, Payer Economics performs complex managed care payer financial analysis, strategic pricing and payer … more
- Intermountain Health (Las Vegas, NV)
- **Job Description:** The Payer Contracting Manager is responsible for effective management of assigned payer contracts, including supporting contract ... relationships. This leadership role manages all aspects of assigned payer contracts, including contract management, relationship management, dispute resolution, rate… more
- AbbVie (Irvine, CA)
- …LinkedIn and Tik Tok (https://www.tiktok.com/@abbvie) . Job Description AbbVie Director, US Payer Strategy lead is responsible for securing patient access to the ... portfolio of indications for all payer and distribution channels including Commercial health plans, Medicare,...Employer, Health System, and Specialty Pharmacy. The purpose of Payer Strategy is to provide overarching direction and leadership… more
- Henry Ford Health System (Detroit, MI)
- As the Director of Payer Audit - Revenue Cycle, you'll lead a high-performing, system-wide audit team and set the strategy for pre- and post-payment audit processes. ... This is more than managing denials-it's about driving payer behavior change, leveraging data to influence outcomes, and...If you're a proven leader with deep expertise in payer audits and a passion for collaboration, innovation, and… more
- Walmart (Bentonville, AR)
- **Position Summary ** As Director, Payer Programs (Rx Clinical Services), you will lead pharmacy clinical services contracting and payer relationship development ... drive sustainable value for Walmart Health & Wellness. By establishing strong payer partnerships, you will expand access to affordable pharmacist-led care in… more
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