- CommonSpirit Health (Rancho Cordova, CA)
- …and support all stakeholders through ongoing educational and problem-solving support for managed care payer reimbursement models. This position requires ... Senior Analyst, Payer Analytics & Economics performs managed care financial analysis, strategic pricing and...modeling of proposed/existing payer contracts negotiated by payer strategy and operations , including expected and… more
- CommonSpirit Health (Englewood, CO)
- …our contract modeling system. The Senior Analyst, Payer Economics performs complex managed care payer financial analysis, strategic pricing and payer ... and support all stakeholders through ongoing educational and problem-solving support for managed care payer reimbursement models. This position requires… more
- NTT DATA North America (Louisville, KY)
- …for the people who work here. NTT DATA Services currently seeks a **Epic Payer Platform Operations Analyst** to join our team in **Louisville, Kentucky.** The ... Epic Payer Platform Operations Analyst is responsible for...discovery, prior authorization, claims status, clinical data retrieval, and care gap closure. You will manage operational runbooks, environment… more
- Baylor Scott & White Health (Dallas, TX)
- …serves as a critical liaison between Revenue Cycle leadership and Managed Care leadership to support and streamline payer communications. The Director will ... organizational structure, collaborating closely with teams across Revenue Cycle, Managed Care , Finance, and Operations ....payer scorecards and performance evaluations * Assist the Managed Care department in preparing for regular… more
- CommonSpirit Health (Phoenix, AZ)
- …and negotiation skills, a comprehensive understanding of healthcare reimbursement methodologies, managed care models, and regulatory requirements, and proven ... reimbursement rates associated language, between physicians/hospitals and payers/networks for managed care contracting initiatives. + Review and accurately… more
- Albany Medical Center (Albany, NY)
- …measure payer compliance with contract terms and overall efficiency of payer operations ; leads reviews with payers providing constructive feedback with ... relevant experience in the management and negotiation of health care payer contracts and network management experience...Demonstrated knowledge of current federal and NYS regulations regarding managed care contracting, as well as the… more
- Waystar (Atlanta, GA)
- …Develop and maintain strong relationships with payers, including health insurance companies, managed care organizations, and government agencies. + Create new, ... payer strategies. This role will report to the Sr Director of Product Operations . **WHAT YOU'LL DO** ** Payer Relationship Management:** + Identify payer … more
- Ascension Health (Nashville, TN)
- …negotiations and payer relationships forward. We are looking for a seasoned managed care leader who seeks innovation and data-driven problem solving, who can ... **Integrate Business Vision:** Bridge the gap between contracting and operations by aligning payer strategies with long-term...key to our commitment of transforming healthcare and providing care to all, especially those most in need. Join… more
- UNC Health Care (Morrisville, NC)
- …assessment, negotiation, implementation, and management of: commercial fee-for-service and value-based managed care payer contracts; Medicare Advantage and ... executive team, reporting to the System Vice President of Managed Care . All payer relationships...System, in a department that provides shared services to operations across UNC Health Care ; except that,… more
- Organon & Co. (Dover, DE)
- …with analytical capabilities. + Highly developed Leadership Skills. + Working Knowledge: Managed Care Operations , Contracting Strategy, Healthcare Systems ... **Job Description** **The Position** The Regional Payer Account Director (RPAD) reports directly to the...and Skills** + BA/BS. + Two plus years of managed care account manager or equivalent experience.… more
- Amgen (Washington, DC)
- …is integral to Amgen's financial performance and will lead contracting activities for Amgen's Managed Care Organization (MCO) customers. As a member of the US ... and transform the lives of patients while transforming your career. **Senior Associate - Payer Contracting (US - Remote)** **What you will do** Let's do this. Let's… more
- UNC Health Care (Morrisville, NC)
- …will in the future, affect UNC Health. Responsibilities: 1. Managed Care Analysis- Research, coordinate and analyze Payer Reimbursement Policies and ... well-being of the unique communities we serve. Summary: The Managed Care Coordinator assists in the day-...System, in a department that provides shared services to operations across UNC Health Care ; except that,… more
- Truman Medical Centers (Kansas City, MO)
- …** + Develop and implement innovative short- and long-term strategies to optimize managed care operations and financial performance. + Oversee budgeting, ... executive leadership team, responsible for driving all aspects of managed care strategy, operations , and...results-oriented leader with deep expertise in managed care , a proven record of successful payer … more
- AccentCare, Inc. (Dallas, TX)
- Overview Managed Care Contract Specialist Location: Dallas Corporate Office Position: Managed Care Contract Specialist Position Type: Full-Time ... this role. Find Your Passion and Purpose as a Managed Care Contract Specialist What You Need...accurate loading of contract terms for Intake, RCM and Operations , as well as assist with as well as… more
- Guidehouse (Chicago, IL)
- …translates healthcare data into measurable healthcare financial performance. This role is dedicated to managed care contracting - you will learn to read payer ... AR days, first pass yield, cash acceleration, net revenue). + Work with Managed Care /Finance, Revenue Integrity/CDM, PFS, and IT/Data teams to align… more
- Huron Consulting Group (Chicago, IL)
- …Huron offers a rewarding path forward. As the Healthcare Consulting Senior Director - Managed Care & Payment Strategy, you will: + Lead complex healthcare ... design, ACO development (eg, MSSP, ACO REACH, Commercial shared risks), Medicaid managed care participation. Experience with population health initiatives such… more
- Insight Global (Fountain Valley, CA)
- …and building Enrollment File and Capitation R&R workflows. Knowledge of managed care operations and payer provider contracting Familiarity HL7, X12, XML, ... understanding of HIPAA transaction sets High-level project management experience Minimum 5 years of experience in EDI operations within a healthcare environment. more
- TEKsystems (Chula Vista, CA)
- …experience implementing conversational AI in healthcare or provider portals. + Experience in managed care or payer -side systems. + Experience with MLOps ... to improve provider experiences, reduce call volume, and deliver personalized, accessible care . This role will directly shape the future of AI-assisted provider… more
- Beth Israel Lahey Health (Wakefield, MA)
- …Certification & Registration: None Experience: 1. 3 - 5 years of experience in managed care operations , with working knowledge of finance, practice ... Operations will assist in overseeing and managing operations and payer partnerships for all BILHPN...management, and quality improvement relevant to outpatient care . 2. Experience in planning, developing, organizing, financing, staffing,… more
- CentraCare (St. Cloud, MN)
- …in a healthcare environment. + Understanding of Medicare and Medicaid payment systems, managed care contracts, and payer policies required. + Proficiency ... care , revenue cycle, government reimbursement, compliance, and clinical operations teams to ensure alignment with payer ...as a liaison between Finance, Compliance, Managed Care , Revenue Cycle, and Clinical Operations teams.… more