- Waystar (Lehi, UT)
- …Develop and maintain strong relationships with payers, including health insurance companies, managed care organizations, and government agencies. + Create new, ... the purpose of this position?** The Vice President of Payer Relations is responsible for initiatives to create innovative...in the formulation and/or update of the business unit operations and annual strategic plan. + Directs the formulation… more
- HCA Healthcare (Brentwood, TN)
- …and prevention of denials, payment discrepancies and other claims adjudication issues from HCA's managed care book of business. Note: This is a position within ... **Qualifications:** + 3+ years of relevant work experience + College Graduate Preferred + Managed Care or Revenue Cycle experience, specifically in the areas of… more
- Organon & Co. (Lansdale, PA)
- …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
- University of Miami (Medley, FL)
- …Business Development and Managed Care is currently seeking an Executive Director, Managed Care Operations to work at our offices in Medley, Florida. ... The Executive Director, Managed Care Operations develops, implements,...and Contract Implementation, Provider Data Management & Credentialing Downstream Payer Relations, Contract Lifecycle Management and Auditing for all… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Managed Care Financial Analyst, Managed Care Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is the ... "Best Employer" seven times. Position Summary: In conjunction with others in the Managed Care Department, this position is responsible for assisting in the… more
- CVS Health (Wellesley, MA)
- …short-term, and long-term goals. + 3+ years of analytical experience within pharmacy, healthcare, managed care , or related field + 3+ years of experience using ... set expectations with stakeholders by partnering closely with Store Operations , Network Operations , Payer Relations...+ 5+ years of analytical experience within pharmacy, healthcare, managed care , or related field + 5+… more
- Hackensack Meridian Health (Edison, NJ)
- … Managed Care Quality and Value Based Care and Director, Managed Care Operations to achieve optimal clinical and underpayment appeals and ... of positive change. The **Senior Vice President (SVP) of Managed Care ** is a critical leadership role...Legal prior to execution. + Cultivate and manage key payer relationships, representing HMH in external vendor meetings and… more
- AccentCare, Inc. (TX)
- Overview Find Your Passion and Purpose as a Director Managed Care Contracting-Remote Reimagine Your Career in Corporate Healthcare As a professional, you know ... Experience What You Need to Know The Director of Managed Care is responsible for negotiation and...Care is responsible for negotiation and management of payer contracts for AccentCare Home Health, Hospice and Palliative… more
- McLaren Health Care (Auburn Hills, MI)
- …escalated contractual, payor policy and operational issues through collaboration with managed care organizations and internal stakeholders. 7. Facilitates Joint ... is to support physician offices in all aspects of care delivery and operations including clinical integration,...an Associate degree and two (2) years' experience in managed care ; or a high school diploma… more
- Baylor Scott & White Health (Dallas, TX)
- …reporting of expenses and operating/net income by entity and line of business. ** MANAGED CARE ANALYTICS & CONTRACT SPECIFIC RESPONSIBILITIES** + Manage team of ... analysts who perform payer performance analytics and modeling for the System. Modeling...of policies, guidelines and supporting documentation to address key managed care initiatives for the System in… more
- CommonSpirit Health (Phoenix, AZ)
- …combination of educationand/orexperience may be considered. + Experience working with managed care contracts, including contract negotiation and analysis ... more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 137 hospital-based locations, in addition to its home-based services… more
- CSL Behring (King Of Prussia, PA)
- …such as Asembia, PCMA. + Collaborate with Marketing, Market Access, Sales, Commercial Operations and Medical Affairs to align strategies and meet joint brand and ... approach to account management. + Advise commercial leadership regarding payer and SP market trends, landscape changes and policies...loved ones. CSL offers resources and benefits, from health care to financial protection, so you can focus on… more
- Tufts Medicine (Burlington, MA)
- …Qualifications:** 1. Bachelor's degree. 2. Seven (7) years of experience in health plans, managed care , practice management, physician liaison or health care ... with LCO leadership regarding contract terms. 7. Coordinates and leads assigned payer operations and performance meetings with coordination of necessary internal… more
- HCA Healthcare (Nashville, TN)
- …Director of Payer Contracting and Alignment, coordinate and administer managed care contract negotiation process for designated Division/Market /Practice ... knowledge of Excel + Negotiation skills + Knowledge of Managed Care Environment + Familiarity with Physician/ Payer contract language + Good communication… more
- Community Health Systems (Franklin, TN)
- …+ Tracks and analyzes payer trends, behaviors, and common issues, collaborating with managed care and contracting teams to improve payer negotiations and ... operations required + Experience working with physician advisors, case management, managed care , or insurance payers preferred **Knowledge, Skills and… more
- Ascendis Pharma (Princeton, NJ)
- …administration of rebate programs, including government rebates (eg, Medicaid, Medicare), managed care rebates, and commercial rebates. Ensure accurate ... formulary validation processes accurately and before payment deadlines, oversee payments of managed care and government rebates, and manage Market Access… more
- Endo International (Nashville, TN)
- …Biopharma industry required. + Three years' experience in 3rd party reimbursement and managed care experience + Significant experience in patient access support, ... provider offices to help their patients get access to care to get them back to living their best...testosterone products with multiple acquisition options within a changing payer landscape. This includes payer policies, prior… more
- R1 RCM (GA)
- …our clients. Every day you will perform resolution analysis which includes reviewing managed care contracts, state or federal legislation, claims billing, and ... training.** **Here's what you will experience working as an Operations Associate:** + Conduct follow-up calls and payer...only does that drive customer success and improve patient care , but that same enthusiasm is applied to giving… more
- Covenant Health Inc. (Knoxville, TN)
- …position is responsible for prioritizing and managing tasks in the Managed Care department in regards to Payer Enrollment and Hospital credentialing. With ... The specialist may do any of the following: process payer enrollment, facility credentialing, pro-fee enrollment, expirables, hospital credentialing /… more
- Dignity Health (Bakersfield, CA)
- …care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups hospitals ... CommonSpirit Health's strategy to transform care delivery through value based care . Working in partnership with CommonSpirit Payer Strategy and Relationships… more