- Datavant (Sacramento, CA)
- …our bold vision for healthcare. **What We're Looking For:** We are seeking a Contract Manager to join our Commercial Operations team. This role will oversee ... the management of our Salesforce contract repository, ensure accuracy and completeness of contract records, and partner with Sales Operations to streamline … more
- Providence (Burbank, CA)
- …insurance benefits investigation, prior authorizations, delivery ticket accuracy; evaluating new payer contracts; payer contract compliance; vendor and ... **Description** Manager Pharmacy Business - Home Infusion - St....Six Sigma training and experience. + Vendor or payor contract negotiation experience. **Why Join Providence?** Our best-in-class benefits… more
- University of Southern California (Los Angeles, CA)
- …team in the management of specific patient populations. The RN case manager role integrates the functions of utilization management, quality management, discharge ... delays in the M drive. * Maintains awareness of current managed care contract requirements. * Participates in appeal process. * Performs and documents InterQual… more
- Robert Half Accountemps (Sacramento, CA)
- Description We are looking for an experienced Billing Supervisor/ Manager to join our team in Sacramento, California. This contract to hire position involves ... collections, including supervisory roles. * Expertise in handling medical denials, payer issues, and reimbursement rates. * Proficiency in using billing software.… more
- Maxim Healthcare (San Jose, CA)
- …annual bonus paid out quarterly Maxim Healthcare is hiring a Clinical Manager to provide management and oversight of clinical supervisors and clinical personnel ... and accountable with all industry regulations including federal, state, local contract and program requirements, and Maxim requirements Qualifications: + Active… more
- Surgery Care Affiliates (Long Beach, CA)
- …Orientation: + Calculate co-pay, and estimated co-insurance due from patients per the individual payer contract per the individual payer contract and ... be added to the patient account ensuring the appropriate payer is selected for Primary insurance. + Utilize the...the patient's insurance is Out of Network notify the manager immediately. Follow the Policies and Procedures when accepting… more
- Cardinal Health (Sacramento, CA)
- …need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutions-driving brand and patient ... activity owners are missing deadlines consistently and/or are unresponsive. + Managing contract amendments and project change requests for the client. + Coordinates… more
- Centene Corporation (Sacramento, CA)
- …management activities to ensure compliance with current state, federal, and third-party payer regulators + Provides education to members and their families on ... Health Professional (eg, LCSW, LMSW, LMFT, LMHC, LPC) or RN based on state contract requirements with BH experience required Pay Range: $26.50 - $47.59 per hour… more
- Fresenius Medical Center (Los Angeles, CA)
- …report and payer mix reports. + Development and maintenance of contract and commercial patient database(s). + Responsible for preparing and updating monthly ... various national and global financial analyses to assist with contract proposals including determining project specifications and review methodologies....of data and reporting. + Provides consolidated business / payer mix / revenue by payer /… more
- Scripps Health (San Diego, CA)
- …improvement in efficiency and excellence. * Direct supervision of vendor contract , including Timely, accurate and consistent fulfillment of negotiated deliverables; ... Scheduled performance review and reporting; Invoice monitoring and payment; contract updates as needed; Regular meeting / updates on vendor results; Review of… more
- Open Mind Health (CA)
- …policies to ensure smooth operations and high compliance. + Assist with periodic payer contract reviews. + Actively seeks continuous quality improvement and ... LOCATION: REMOTE REPORTS TO: CLIENT LIAISON MANAGER ABOUT OPEN MIND HEALTH We are a...ongoing monitoring. + Has worked with a variety of payer portals including Aetna, Blue Cross Blue Shield, Optum,… more
- University of Southern California (Alhambra, CA)
- …versus clinical-related denials, evaluating claims deemed inappropriately paid by the payer /external auditors, and determining the need for appeal. Performs all 1st ... claims. Prepares appeals and rebuttals letters/packages in responses to payer 's reason for coding-related 'claims denials' and 'claims rejections'-including… more
- Cedars-Sinai (Beverly Hills, CA)
- …pharmacy analytics and reporting. Under the direction of the Pharmacy Manager , the coordinator applies data-driven methodologies to improve specialty pharmacy ... operations and monitor payer formulary and access changes. This position ensures compliance...parties such as accreditation bodies, drug manufacturers, payers, and contract pharmacies. **Why work here?** Beyond outstanding employee benefits… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …and is responsible for negotiating, implementing, and monitoring of hospital payer contractual agreements. This position involves frequent interactions with the ... and capitation arrangements for all Health System Entities while developing contract negotiation strategies that balance alignment with Rady Children's strategic… more
- AbbVie (Los Angeles, CA)
- …are met or exceeded. Leverage data analytics (eg, MABI) to assess contract effectiveness, inform future initiatives, and continuously refine overall performance and ... Life Sciences, or a related field + 5+ years sales management (District Manager or Regional Manager preferred) + Account management and/or marketing experience… more