- Humana (Trenton, NJ)
- …our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... the Pricer Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support… more
- Guidehouse (New York, NY)
- …and third party payer accounts that are subject to pre-bill claim edits, hospital billing scrubber bill hold edits, and claim denials. **This position is 100% ... for charge reconciliation audits + Escalate departments noncompliant with policy and provide action plan when needed + Responsible for the daily resolution of… more
- Mount Sinai Health System (New York, NY)
- …quality of care and research. We have over 38,000 employees working together to provide billions of dollars in high-quality care each year for millions of patients. ... to keep entire communities healthy and out of the hospital . Mount Sinai Health Partners (MSHP) is the team...to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's… more
- Option Care Health (Trenton, NJ)
- **Extraordinary Careers. Endless Possibilities.** **With the nation's largest home infusion provider , there is no limit to the growth of your career.** Option Care ... the largest independent home and alternate site infusion services provider in the United States. With over 8,000 team...and more impactful. Our organization requires extraordinary people to provide extraordinary care, so we are investing in a… more
- Humana (Trenton, NJ)
- …- 5 years of experience in negotiating managed care contracts with physician, hospital and/or other provider contracts. + Proficiency in analyzing, understanding ... part of our caring community and help us put health first** The Provider Contracting Professional 2 initiates, negotiates, and executes dental provider contracts… more
- Mount Sinai Health System (New York, NY)
- …organization and bridges the gap between clinical care and medical billing and reimbursement . This position will report to the Senior Director. This role will serve ... cycle, ensuring that patient care translates into accurate and timely reimbursement , safeguarding the financial well-being of the organization and contributing to… more
- Mount Sinai Health System (New York, NY)
- …quality of care and research. We have over 38,000 employees working together to provide billions of dollars in high-quality care each year for millions of patients. ... to keep entire communities healthy and out of the hospital . Mount Sinai Health Partners (MSHP) is the team...to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's… more
- Ascendis Pharma (Princeton, NJ)
- …deep understanding of US government pricing programs, and the pharmaceutical reimbursement landscape. Key Responsibilities + Lead the end-to-end government pricing ... and annual GP reports to CMS, VA/DoD, and state Medicaid agencies, and any programs requiring price reporting, per...any programs requiring price reporting, per legislative requirements + Provide government pricing impact assessments to aid in the… more
- Ascendis Pharma (Princeton, NJ)
- …managers (PBMs). This role requires expertise in contract management and reimbursement dynamics, coupled with strong leadership and analytical skills. The Director, ... and manage accruals for applicable vendor purchase orders. Assess and provide input to department's overall yearly budget. Requirements Key Responsibilities:… more
- Oracle (Trenton, NJ)
- …focus more on patient care by reducing administrative burden of clinical and reimbursement tasks such as charting, documentation, and coding by applying power of ... opportunities to prevent future denials, and ensure maximum appropriate reimbursement . This role is critical for financial recovery and...on experience preparing appeals for claim denials in the hospital and ambulatory setting + 3+ years hands on… more
- Molina Healthcare (New York, NY)
- …modeling current and future contract rate proposals. + Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact of ... Business Intelligence tools (Medinsight, PowerBI), and Executive Dashboard. + Generate hospital performance analytics tools on a quarterly basis; develop reports on… more
- Mount Sinai Health System (New York, NY)
- …quality of care and research. We have over 38,000 employees working together to provide billions of dollars in high-quality care each year for millions of patients. ... to keep entire communities healthy and out of the hospital . Mount Sinai Health Partners (MSHP) is the team...to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's… more
- Ascendis Pharma (Princeton, NJ)
- …knowledge of the US healthcare system, payer segments (Commercial, Medicare and Medicaid ) and reimbursement methodologies (eg specialty pharmacy) + Experience ... and executing access strategies and tactics to ensure optimal patient and provider access for products in our Endocrinology Rare Disease portfolio. This role… more
- Genesis Healthcare (Monroe Township, NJ)
- …through the delivery of high-quality care and exceptional service. As a leading provider in the long-term care industry, we believe in fostering a collaborative, ... you comfortable working cross-functionally with departments like Admissions, Clinical Reimbursement , and Social Services to maintain accurate and compliant patient… more
- Allaire Rehab & Nursing (Freehold, NJ)
- …Federal and State regulations and reimbursement (Managed Care, Medicare, and Medicaid ). + Provide assistance with new Stakeholder orientation regarding the ... Spending Account + 401k available + Career advancement opportunities / tuition reimbursement + Complementary uniform + Friendly work environment + Referral bonus +… more
- Sanofi Group (New York, NY)
- …+ Maintain extensive knowledge of the Managed Care, GPOs, Specialty Pharmacy, State Medicaid and Veterans Affairs selling and reimbursement environment for their ... of belumosudil in their assigned geography, if approved. The IHM will provide on-label product information to designated key opinion leaders, health care… more
- Humana (Trenton, NJ)
- …for services rendered is complete, compliant and accurate to support optimal reimbursement . The Nurse Auditor 2 work assignments are varied and frequently require ... in the state they reside. + Minimum of 2 consecutive years acute inpatient hospital care experience in critical, intensive care setting within the last 5 years (Not… more