- Cedars-Sinai (Los Angeles, CA)
- …revenue codes) preferred. *Minimum of 2 years of experience with Managed care contract interpretation and reimbursement analysis preferred. **Why work ... accounts to ensure payment and resolution. + Monitors, evaluates, and reviews Cedars-Sinai Managed Care contracts and reconcile to payments received. + Ensures… more
- Cedars-Sinai (Beverly Hills, CA)
- …implementation financial initiatives; assisting in the interpretation of policies/procedures/practices. Managed Care Reporting: + Prepare reports and ... metrics, identifying trends, variances, and areas for improvement. + Analyze managed care contracts for compliance and financial performance, identifying… more
- Guidehouse (Los Angeles, CA)
- …will be notified by **Friday, Oct. 24** **What You Will Do** **:** Guidehouse's Managed Care practice sits within the broader Payer Provider Advisory group. The ... Managed Care practice assists hospitals, health systems,...to work with our internal teams on the assigned project/ contract , meet with upper management to reflect on your… more
- Sutter Health (Sacramento, CA)
- …financial analysis principles, methods, practices, and procedures. + Knowledge of managed care payment/ reimbursement methodologies (eg, Medicaid/Medi-Cal, ... you are interested in joining Sutter Health! **Organization:** SSC-Sutter Senior Care **Position Overview:** Hybrid position with report requirements in Sacramento,… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …collections of outstanding account balances for commercial, government, and managed care payors as assigned. The Reimbursement Specialist I is required to ... Specialist I to read, interpret and apply complex payor contract language to expected reimbursement calculations and pursue all payments due to the organization.… more
- Highmark Health (Sacramento, CA)
- …Healthcare, Healthcare Insurance, Consulting or related area + 3 years Value-based reimbursement , through managed care contracting, provider reimbursement ... This job supports the matrixed strategic design and analytical approach to reimbursement . To be successful, the incumbent will work closely with stakeholders across… more
- UCLA Health (Los Angeles, CA)
- …+ Manage Medi-Cal Waiver reimbursement , including FFS estimates and Managed Care entitlements. + Track regulatory changes, attend industry conferences, ... a key leadership role within a world-class, award-winning health system. As Senior Reimbursement Manager at UCLA Health, you will oversee complex reimbursement … more
- CommonSpirit Health (Rancho Cordova, CA)
- …position. The Senior Analyst, Payer Analytics & Economics performs managed care financial analysis, strategic pricing and payer contract modeling activities ... Recommends strategies for maximizing reimbursement and market share. Develops new managed care products with external payers that are consistent with… more
- LA Care Health Plan (Los Angeles, CA)
- …Required: Minimum of 6 years of recent care management experience in a managed care setting, such as a health insurance environment and/or experience as ... Manager, Enhanced Care Management (Clinical) Job Category: Clinical Department: ...state/federal compliance are met. + Track data related to contract compliance and member complaints. + Formulate reports and… more
- Alameda Health System (Oakland, CA)
- …Commission, Title 22 and other regulatory agencies and overall hospital policies; integrates managed care contract criteria into overall Case Management ... the VP of CM with completion of financial analyses including cost of care to reimbursement , denials management, and non-reimbursed services, promoting effective… more