- Providence (Anaheim, CA)
- …including insurance benefits investigation, prior authorizations, delivery ticket accuracy; evaluating new payer contracts ; payer contract compliance; ... **Description** Manager Pharmacy Business - Home Infusion - St....Six Sigma training and experience. + Vendor or payor contract negotiation experience. **Why Join Providence?** Our best-in-class benefits… more
- Walgreens (Oakland, CA)
- …and growing the business at the site. Performs all duties of the Pharmacy Manager in their absence. + Models and shares customer service best practices with all ... of prior authorizations on behalf of prescribers. + Works with the Pharmacy Manager toward the success of the pharmacy operation (scheduling, customer service, and… more
- Surgery Care Affiliates (Long Beach, CA)
- …Orientation: + Calculate co-pay, and estimated co-insurance due from patients per the individual payer contract per the individual payer contract and ... process of collecting over the counter payments/deductibles/copay/co-insurance. Knowledge of payer contracts including Medicare, Medicaid and other government… more
- CenterWell (Sacramento, CA)
- …and manage payer configurations, ensuring accuracy and timeliness. + ** Contract Interpretation:** Analyze and interpret complex contracts to ensure ... responsible for supporting the organization's billing operations with a focus on contract interpretation, validation, and payer setup. This role works… more
- Robert Half Accountemps (Sacramento, CA)
- Description We are looking for an experienced Billing Supervisor/ Manager to join our team in Sacramento, California. This contract to hire position involves ... collections, including supervisory roles. * Expertise in handling medical denials, payer issues, and reimbursement rates. * Proficiency in using billing software.… more
- UCLA Health (Los Angeles, CA)
- …the pharmacy analytics field and recognized expertise in financial analysis/transactions, payer contracting, data analytics, and strategic planning. You will provide ... basis for modeling the impact of acceptance or denial of specific third party contracts + Skill in using the following required machines, tools, office and pharmacy… more
- University of Southern California (Alhambra, CA)
- …be followed, based upon the type of financial class, eg, contracts , private insurance carrier, HMOs, government programs, Federal/State/Local, Self-Pay accounts in ... claim form(s) or billing system for which departmental and payer guidelines stipulate should not be billed to the...identified billing issues and trends to Supervisor and Billing Manager in a timely manner. Communicates issues with claim… more
- John Muir Health (Walnut Creek, CA)
- …policies and processes. Serves as the business lead for all pharmacy payer contracts , ensuring appropriate access to commercial and government agreements. ... business performance. (eg Vizient ODB, CDB) Establishes and monitors 340B contract pharmacy agreements and relationships to ensure full compliance and maximize… more
- Lilly (San Diego, CA)
- …product pricing, reimbursement, and access (PRA), grant submissions and contracts ; contacts with regulatory and other governmental agencies; outreach medical ... and Value Proposition that addresses key customer needs (patient, provider, and payer ); the product lifecycle plan, clinical strategies, development plans and study… more
- Open Mind Health (CA)
- …policies to ensure smooth operations and high compliance. + Assist with periodic payer contract reviews. + Actively seeks continuous quality improvement and ... LOCATION: REMOTE REPORTS TO: CLIENT LIAISON MANAGER ABOUT OPEN MIND HEALTH We are a...ongoing monitoring. + Has worked with a variety of payer portals including Aetna, Blue Cross Blue Shield, Optum,… more