- Nuvance Health (Danbury, CT)
- *Description* Summary: The Managed Care Analyst compiles, validates, and analyzes utilization and reimbursement data to aid in contract negotiations for ... entities. In addition to gathering volume data and modeling of current reimbursement, the Managed Care Analyst determines the need for methodology changes… more
- Teva Pharmaceuticals (Parsippany, NJ)
- …in the disputes process. **How you'll spend your day** * The Senior Managed Care Rebate Analyst must interpret contract language and input and maintain ... Senior Managed Care Rebate Analyst ...Senior Managed Care Rebate Analyst Date: Sep 13,...requirements * Analyzes and resolves disputes with accounts involving contract interpretation or processing issues; engages Managed … more
- e CancerCare (Nashville, TN)
- …data to provide in reports, which includes determining the impact of adjustments to managed care reimbursement terms and/or contract compliance, along with ... Job Purpose: Contract Analyst will be responsible for.... Maintain various department spreadsheets and databases. . Review managed care payer contracts with… more
- Prime Healthcare (Ontario, CA)
- …and strong follow-up skills. + Knowledge of CPT, ICD-10 codes, Medicare guidelines, and Managed Care contracts . + Working knowledge of self-funded medical ... California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf Responsibilities The Contracts Analyst originates and maintains physicians and providers … more
- HCA Healthcare (Nashville, TN)
- …you. We want you to apply today! **What you will do in this role:** + Model managed care contracts through the Concuity Calc Engine + Performance of ad hoc ... **Job Summary and Qualifications** Seeking a Contract Analyst , who is responsible for translating managed ...care terms and model relevant parameters in Concuity/Clear Contracts Calc Engine to ensure accurate discounts on patient… more
- Teva Pharmaceuticals (Parsippany, NJ)
- …event of noncompliant formulary findings. **How you'll spend your day** + Review Managed Care Contracts , Formularies, Utilization Management, and PA policies ... Sr. Contract Compliance Analyst Date: Sep 25,...and tier position for biosimilars and pharmacy drugs (Medical Claims/ Managed Care ), and Pharmaceutical contract … more
- Elevance Health (Miami, FL)
- **Provider Contract /Cost of Care Analyst ...a minimum of 3 years experience in broad-based analytical, managed care payor or provider environment as ... within 50 miles of one of Elevance's Pulse Point locations. **The Provider Contract /Cost of Care Analyst Sr.** is responsible for analytical support to the… more
- Pacificorp (Portland, OR)
- Power Purchase Contract Management Analyst (Portland, OR) - 112644 **Date:** Sep 14, 2024 **Location:** PORTLAND, OR, US, 97232 **Company:** PacifiCorp ... + Develop detailed responses to internal and regulator data requests, for managed energy contracts . + Performs related duties as assigned. **Requirements… more
- Vanderbilt University Medical Center (Nashville, TN)
- …as lead on projects. Additional responsibilities include reviewing current managed care contracts , validating contract compliance, and addressing changes ... projects. Additional responsibilities include reviewing current managed care contracts , validating contract compliance,...methodologies used in a clear manner such that another analyst could duplicate the work. + Generates New Ideas:… more
- MyFlorida (Tallahassee, FL)
- …remains informed about regulations of the Agency for Health Care Administration, managed care contracts , as well as Medicaid systems and technology, ... and cost-effectiveness of the Medicaid program related to the managed care programs and contracts ....findings and developing compliance actions as prescribed in the managed care contract (eg, corrective… more
- AdventHealth (Maitland, FL)
- …complete financial and operational analyses of managed care contracts , proposals, analyze fee schedules, and determine contract compliance. The Medical ... + Assists in interpreting analyzed data from various sources using knowledge of healthcare managed care contracts and healthcare administrative claims data +… more
- MyFlorida (Tallahassee, FL)
- … care report guide, Medicaid contracts and amendments; Dear Managed Care Plan letters, contract interpretations, policy transmittals, and provider ... 68064844 - MEDICAL/HEALTH CARE PROGRAM ANALYST Date: Sep 19,...home and community based waivers), administrative rules, coverage policies, managed care plan contracts , bill… more
- AdventHealth (Maitland, FL)
- …Must be able to complete extensive and complex financial and operational analyses of managed care contracts and proposals, analyze fee schedules, and ... determine contract compliance. The Senior Medical Economics analyst must have attention to detail and competencies in...analyze data from various sources using knowledge of healthcare managed care contracts and healthcare… more
- Medical Mutual of Ohio (OH)
- …years of experience as a Provider Reimbursement Analyst or equivalent health care administration experience, preferably in managed care . . Provider ... or related field. . 3-4 years of experience as a Provider Reimbursement Analyst or equivalent progressive health care administration experience with an emphasis… more
- RWJBarnabas Health (Oceanport, NJ)
- …degree in finance or accounting required. + Experience working with complex and sophisticated managed care contracts . + Strong analytical skills with ability ... lead on modeling contract rates throughout the managed care contract negotiation process....cost-based audit reviews. + Supports the loading of payor contracts into the contract management system and… more
- Beth Israel Lahey Health (Charlestown, MA)
- …and performs functions related to other financial aspects of Beth Israel Lahey Health's Managed Care Contracts and relationships. It also requires in-depth ... Designs & performs analyses and reporting in support of managed care contract negotiations including...and performance. 5) Performs ad hoc financial analyses of managed care contracts . 6) Incorporates… more
- Mount Sinai Health System (New York, NY)
- …and Amendments, financial performance for all contracts , and facility, ancillary related contract negotiations. The Managed Care Team is at the forefront ... Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as...and Medicare Contracts with Mount Sinai. The Contract Performance Analyst will be a liaison… more
- Hartford HealthCare (Wethersfield, CT)
- …programs and other common practices across the system. *_Position Summary:_* The Managed Care Contracting organization is seeking a results-oriented, committed, ... Query Language (MSSQL) Database skills to lead/execute the development of the complex Managed Care / Payer Analytics platform. The Payer Analytics team is… more
- Mount Sinai Health System (New York, NY)
- …and Amendments, financial performance for all contracts , and facility, ancillary related contract negotiations. The Managed Care Team is at the forefront ... within MSHP is responsible for the negotiation, implementation and contract compliance related to Facility Contracts for...Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as… more
- City and County of San Francisco (San Francisco, CA)
- Behavioral Health Services (BHS) is increasingly expanding services under its Managed Care division which oversees the Office of Coordinated Care (OCC), ... The Behavioral Health Services (BHS) Deputy Medical Director of Managed Care provides effective leadership and strategic...Health Plan and the Drug Medi-Cal Organized Delivery System contracts with the Department of Health Care … more