- Penn Medicine (Philadelphia, PA)
- …accounts receivable reports, profit and loss statement, and balance sheet accounts. + Lead all data analytics and financial reporting functions for Signature ... Reporting to the COO, Penn Signature Services (PSS), the Director of Finance & Data Analytics is a pivotal leader charged with the oversight of the financial… more
- Trinity Health (Darby, PA)
- …as it relates to proper processing and accuracy of patient stay claims data , denials management, and appeals. Assists RN Manager with establishing tools, processes, ... denials is accurate, consistent and complies with regulatory standards, monitors payor correspondence and tracks and processes appeal outcomes to resolution +… more
- UPMC (Pittsburgh, PA)
- UPMC Corporate is hiring a Decision Support System Coordinator to join our Payor Contract Team! This role will work Monday through Friday during business hours. The ... is responsible for providing financial systems support for UPMC user of Payor Contract Services applications. This position will participate in the system… more
- Bristol Myers Squibb (Philadelphia, PA)
- …presenting relevant formulary information, as well as pharmacoeconomic and clinical data , to support formulary decision making. Collaborating closely with the ... they relate to medical/clinical and health economic and outcome research (HEOR) data with payers, policy makers, and other decision makers and influencers.… more
- Highmark Health (Murrysville, PA)
- …+ Conducts scheduling, and preregistration functions, validates patient demographic data , identifies and verifies medical benefits, accurate plan code and ... COB order. Obtains limited clinical data based on service required. Corrects and updates all...accurate bill submission. (20%) + Verifies insurance information through payor contacts via telephone, online resources, or electronic verification… more
- Sharecare, Inc. (Harrisburg, PA)
- …unify and manage all their health in one place. Our comprehensive and data -driven virtual health platform is designed to help people, providers, employers, health ... completing and submitting Sharecare proposal responses. **Essential Job Functions:** + Lead development and writing of proposals as assigned, including those that… more
- Takeda Pharmaceuticals (Harrisburg, PA)
- …including but not limited to: + Sales reporting + Incentive Compensation + Data & Information Management + Sales Resource Deployment, Analytics & Reporting + Field ... Congress Portfolio Strategy + Budget Management + Communications + Lead a team of individuals who will drive business...Insights teams, develop action plan and oversight of ensuring data and reflective of the market and supports market… more
- Gilead Sciences, Inc. (Philadelphia, PA)
- …Kite, we empower our leaders to step up, share ideas, listen, learn, and lead . We're welcoming bright, diverse, and imaginative minds; we're nurturing them to foster ... Identify and align all cross-functional partners (medical, value and access, payor , marketing, logistics, etc.) to strengthen collaborative relationships within and… more
- Highmark Health (Pittsburgh, PA)
- …the domains of reimbursement and network programs. Specifically, the incumbent will lead the strategy and creation of value-based reimbursement (VBR) & risk ... organization competitively based on market trends and forecasting. + Lead the team that builds, updates, and maintains and...7 years in Healthcare Strategy, with strong preference for Payor experience + Extensive knowledge of new and emerging… more
- Humana (Harrisburg, PA)
- …owner), Main Line Health System, and Jefferson Health System. Humana takes the lead in providing administrative support in various areas including HR. DVACO's MSSP ... through various DVACO departments including Care Coordination, Practice Transformation, Data Analytics, Post-Acute Care and Clinical Quality, and the opportunity… more
- Trinity Health (Darby, PA)
- …medical necessity criteria including InterQual, Milliman Care Guidelines (MCG), and payor guidelines. Reduces unnecessary admissions to the acute care hospital. Has ... of ED status availability + Participates in identifying, collecting, and analyzing data to support clinical care **Our Commitment to Diversity and Inclusion**… more
- Trinity Health (Newtown Square, PA)
- …to healthcare financial operations and an understanding of external, regulatory, payor and other forces impacting health care financial operations including US ... appropriate for role. **Process Focus:** Utilizes multiple system applications for data collection & management. Knows, understands & incorporates basic knowledge of… more