- Datavant (Boston, MA)
- …with a primary focus on Apixio. This role will report directly to Manager , Payer Billing & Collections, and will collaborate cross-functionally with teams ... experiences to realize our bold vision for healthcare. **Role Summary** The Payer Billing & Collections Specialist is responsible for managing day-to-day billing,… more
- Takeda Pharmaceuticals (Boston, MA)
- …and process rebates and fees within ModelN FLEX revenue management system for both Payer and GPO contracts . Support data requests from US OBU Patient Value ... bring all issues to a satisfactory resolution. + Gather Payer claim level data files, reconcile Payer ...experience in the pharmaceutical industry required. + ModelN/Flex Revenue Manager experience in contract implementation and maintenance… more
- East Boston Neighborhood Health Center (East Boston, MA)
- …outpatient and ambulatory pharmacy locations, ensuring all documentation (licenses, registrations, payer contracts , portal user names and passwords, etc.) and ... you're a nurse or physician providing direct care, a manager leading dedicated teams, or part of the essential...NeighborHealth's 340B pharmacy program. This entails a focus on contract pharmacy management through 340B ESP, 340B audit preparation,… more
- Commonwealth Care Alliance (Boston, MA)
- …instED operations, from contracting to go-live.. Within this team, the Implementation Manager serves a critical role in driving the implementation of instED's growth ... all levels, as well as with stakeholders from outside the organization. The Implementation Manager must be a proactive problem solver, with a strong bias for action,… more
- Beth Israel Lahey Health (Plymouth, MA)
- …resolution, monitoring & reporting of clinical denials. + Maintains current knowledge of payer contract changes as they pertain to level of care determination ... Full Time **Job Description:** **Utilization Review & Denials management manager - Full Time** **Who We Are:** At **Beth...knowledge of InterQual Level of Care Criteria. + Understands payer contractual guidelines for all third party and government… more
- Takeda Pharmaceuticals (Cambridge, MA)
- …is true to the best of my knowledge. **Job Description** Join Takeda as the Manager of Price and Gross-to-Net (GTN) Forecasting within the US Business Unit. For this ... discounting components for your portfolio products - including Medicare, Medicaid, payer and incentive rebates, chargebacks, and government pricing calculations (ASP… more
- Fresenius Medical Center (Boston, MA)
- …report and payer mix reports. + Development and maintenance of contract and commercial patient database(s). + Responsible for preparing and updating monthly ... various national and global financial analyses to assist with contract proposals including determining project specifications and review methodologies. Analyses… more
- Cardinal Health (Boston, MA)
- …need for a better quality of life. Our diverse expertise in pharma, payer , and hub services allows us to deliver best-in-class solutions-driving brand and patient ... + Oversee employee schedules to ensure proper business coverage as outlined by client contracts and company policies + Set priorities for the team to ensure task… more
- Cardinal Health (Boston, MA)
- …need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutions-driving brand and patient ... activity owners are missing deadlines consistently and/or are unresponsive. + Managing contract amendments and project change requests for the client. + Coordinates… more
- Dana-Farber Cancer Institute (Boston, MA)
- …of practitioners as outlined in the medical staff bylaws, policies or related contracts or as required by accrediting and regulatory agencies (ie, TJC, CMS, NCQA). ... evaluation, validates discrepancies, and ensures appropriate follow up with Manager /Supervisor. + Prepares credentials file through completion and presentation to… more