- Novo Nordisk Inc. (Santa Barbara, CA)
- …co-promotion partners. Internally, the CMCS I reports to the Portfolio District Business Manager of the specific sales territory. The CMCS I also interacts and ... of the local payer market including Medicare, Commercial and Medicaid benefit designs, Payer Coverage, Prescription Coverage Requirements, Step Therapy,… more
- Commonwealth Care Alliance (Boston, MA)
- …account manager , relationship manager , and performance partner - using data , provider feedback, and system collaboration to enhance provider ... Engagement & Performance Position Summary: The Behavioral Health (BH) Provider Engagement Program Manager is responsible for...and Data Insight - Analyze and interpret provider data related to utilization, cost, quality,… more
- Commonwealth Care Alliance (Boston, MA)
- 011230 CA- Provider Engagement & Performance **Position Summary** The Program Manager , in collaboration with the Sr Director of Delegation Partnerships and ... and Systems (CAHPS), and social determinants of health (SDOH) measures. The Program Manager will work collaboratively with our provider network and Quality teams… more
- Commonwealth Care Alliance (Boston, MA)
- 011230 CA- Provider Engagement & Performance **Position Summary:** The Provider Communications Manager is a key contributor responsible for building and ... executing communication strategies that foster strong, collaborative relationships with provider partners serving dual-eligible (Medicare- Medicaid ) members. This… more
- Commonwealth Care Alliance (Boston, MA)
- …systems, large medical groups, and specialty care networks. - Experience supporting provider data integrity, onboarding, and credentialing processes. - Proven ... and retention. - Lead ongoing communication efforts, working closely with Provider Communications Manager , to keep providers informed of organizational… more
- Commonwealth Care Alliance (Boston, MA)
- …to care. Reporting to the Senior , Director of Delegation Partnerships., the Senior Provider Relations Account Manager will: + Lead provider servicing ... provider engagement strategy, focused on delivering a best-in-class provider experience. + Utilize strategic planning and data -driven insights… more
- Commonwealth Care Alliance (Boston, MA)
- 011230 CA- Provider Engagement & Performance Position Summary: The Provider Delegation Performance Manager is responsible for overseeing and improving the ... as mid-year and annual reviews and program-wide performance summaries. - Support delegated provider staff in using data tools effectively and understanding … more
- Sun Pharmaceuticals, Inc (Washington, DC)
- …developed analytical skills with demonstrated ability to conceptualize issues and synthesize data to provide strategic direction Experience in Sun Pharmas ... Field Reimbursement Manager Overview: The Field Reimbursement Manager ...(coverage, coding & payment), specialty pharmacy and distribution processes, provider support services (eg, benefits investigation) and patient support… more
- Katmai (Usaf Academy, CO)
- …services for eligible patients based on subjective and objective assessment data and identified patient/family needs. + Facilitates a multidisciplinary team to ... worker license in good standing. + Extensive knowledge of TRICARE, Medicare/ Medicaid services and benefits is mandatory. + Knowledge of professional care… more
- National Health Care Associates (Ridgefield, CT)
- …valued and appreciated. We invite you to join our team! **-** **Business Office Manager ** **Full-Time** **What You'll Do:** As a Business Office Manager , you are ... ensure regulatory compliance and that resources are optimized to provide the best care for our residents. **Key Responsibilities:**...you to join our team as a Business Office Manager . **-** **What We Offer** As an affiliate of… more
- Lyric (Newtown Square, PA)
- …and other immigration support are not available for this position. The Senior Manager , Clinical Content Maintenance will serve as a strategic partner to our clients, ... Content Analysts. In this intricate role, the Senior Clinical Manager will combine their deep knowledge of CPT, HCPCS,...coding and claims edit logic (including NCCI, LCDs, State Medicaid , MUEs, Lyric edits and payer medical policies) +… more
- Centers for Independence (Milwaukee, WI)
- …radius on a regular basis and farther distances between regions when needed to provide coverage for other ICs. + Responsible for accurate and timely completion of ... in maintaining financial eligibility by keeping record of when Medicaid reviews are due and by assisting participants in...basis and farther distances between regions when needed to provide coverage for other ICs by personal vehicle within… more
- Stony Brook University (Stony Brook, NY)
- …for services. + Active participation in performance improvement, department activities and data collection efforts. + Provide proactive health care for geriatric ... Outpatient Care Manager **Position Summary** At Stony Brook Medicine, a...+ Actively participates with insurance company and physician to provide authorizations for clinical and all potential medical interventions.… more
- Commonwealth Care Alliance (Boston, MA)
- …to include accurate ASAP, LTSC Agency, GSSC and LTSC, among other details o Coordinate Provider Rosters with the Provider Data Networks Team - Disseminate ... support o Link with CCA's Business Intelligence team and Provider Engagement Analytics Manager to request reports...Manager to request reports as needed o Perform data quality checks, and additional data review… more
- Cordis (New York, NY)
- …lives.** Come be a vital member of the Sales team at Cordis! The **Territory Manager ** position offers you the opportunity to play a huge role in the success of ... accounts + Demonstrate outstanding product knowledge, understanding of related clinical data , competitive product knowledge, & overall industry trends + Cold… more
- Children's Hospital Los Angeles (Los Angeles, CA)
- …independent judgment. Communicates technical or general information to their manager , director, & medical staff. Participate in administrative activities. Provides ... expertise and serves as a technical resource for others. May provide functional supervision to support staff. **Minimum Qualifications/Work Experience:** + Minimum 1… more
- Moses/Weitzman Health System (Middletown, CT)
- …member of the AR team phone queue + Cross trains within department to provide coverage when necessary + Collaborates with Office Mgr's regarding quality of data ... + Organizes work load to achieve a high level of productivity + Notifies Manager of information that negatively impacts production + Assist with special projects as… more
- CVS Health (St. Paul, MN)
- …all with heart, each and every day. **Position Summary** + Lead a team of Medicaid Provider Data Services Analysts responsible for loading and maintaining ... Medicaid Provider data within Aetna QNXT. + Team...Medicaid Provider data within Aetna QNXT. + Team...or Network operations. + 1+ years of experience in Medicaid provider operations. + At least 1… more
- Humana (Albany, NY)
- …Pricer Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support existing ... be primarily responsible for implementation, maintenance and support of Medicaid provider reimbursement for hospitals and facilities....EAPG + 2+ years of experience with Optum Rate Manager + 2+ years of experience with Optum WebStrat… more
- CVS Health (Annapolis, MD)
- … Manager of Claims Management is responsible for overseeing Medicaid claims operations, inventory management, quality assurance, and compliance monitoring. This ... federal regulations, contractual requirements, and organizational performance standards. The manager partners cross-functionally with Provider Relations, Configuration,… more
