- OU Health (Oklahoma City, OK)
- …renegotiated managed care agreements for the OU Health system, and develop payor strategies to ensure optimal contracting and operational performance. The Director, ... stakeholders.Negotiate contract language and performance terms. This includes legal, compliance , quality measures, reporting and data exchange requirements.Lead implementation… more
- Covenant Health Inc. (Knoxville, TN)
- …Overview: Covenant Health is East Tennessee's top-performing healthcare network with 10 hospitals (http://www.covenanthealth.com/hospitals/) and over 85 outpatient ... work for i npatient accounts. Work involves leading or conducting coding and compliance audit projects for Covenant Health entities as they relate to coding,… more
- Covenant Health Inc. (Knoxville, TN)
- … requirements, and self-pay/uninsured patient requirements assuring departmental compliance . + Recognizes situations, which necessitate supervision and guidance, ... of applicable training manuals. + Distributes CMS and other payor memos to staff, and provides training for new...and provides training for new or revised rules ensuring, compliance with CMS/Tenncare/Medicaid or other State or Federal regulations.… more
- Providence (Burbank, CA)
- …the proper preparation and coordination of resources needed to achieve regulatory compliance related to the CMS COP Quality Assessment and Performance Improvement ... developed action plans. + Oversees the submission of outcomes data for different payor designations and programs, eg, Blue Distinction, Anthem, etc. + Oversees the… more
- Gilead Sciences, Inc. (Chicago, IL)
- …and Michigan) will support the demand enablement at the Approved Treatment Center (ATC) network level with the goal of increasing class share, and Kite brand share, ... to:** + **Demand Enablement:** + Enable demand within ATC network (ATC, Satellite network and community as...and senior stakeholders at individual ATCs to strengthen ATC relations and drive demand enablement, with a focus on… more
- Cardinal Health (Columbus, OH)
- …revenue cycle management, patient growth and practice marketing, value-based care, payor relations , EHR, clinical operations, and awareness of regulatory ... areas including administrative, clinical, human resources, practice marketing, finance, IT and compliance . You will serve as point contact for physician leaders and… more
- Methodist Health System (Dallas, TX)
- …- Investigate and address claim denials promptly. Utilize knowledge of payor policies, medical coding guidelines, and billing regulations to appeal denials ... in healthcare regulations, coding guidelines, and billing requirements. Ensure compliance with HIPAA, CMS, and other regulatory standards governing healthcare… more
- University of Miami (Coral Gables, FL)
- …will oversee and develop communication strategies, execute crisis management, media relations , and engagement campaigns, appealing to diverse and unique audiences. ... organizational "buy in" to achieve goals. * Ensures internal control oversight and compliance with laws and regulations, safeguarding of assets, compliance with… more
- Banner Health (Phoenix, AZ)
- …procedures and programs aligned with stated goals and objectives. Ensures compliance with applicable Federal and State regulations and established organizational ... accreditations, as well as development of a community-based physician referral network 9. This position has full operational and administrative oversight… more
- Henry Ford Health System (Detroit, MI)
- …accordance with current standards and regulations and must maintain stringent compliance with payers. The Provider Enrollment Specialist maintains excellent ... relations and is the main liaison between payers, clinics,...up conversations. + In depth working knowledge of various payor applications associated with the workflow process, ie, Webdenis,… more
- Spaulding Rehabilitation (Charlestown, MA)
- …Representative - ( 3284050 ) **Description** **Summary** Participate in referral relations activities within an inpatient healthcare setting and conduct preadmission ... scope of care according to established guidelines and in compliance with local, state and federal regulations, including LTAC,...the appropriate plan to meet the patients' needs. + Payor mix results are achieved according to established targets.… more
- Spaulding Rehabilitation (Brighton, MA)
- …Representative - ( 3288183 ) **Description** **Summary** Participate in referral relations activities within an inpatient healthcare setting and conduct preadmission ... scope of care according to established guidelines and in compliance with local, state and federal regulations, including LTAC,...the appropriate plan to meet the patients' needs. * Payor mix results are achieved according to established targets.… more
