- Dignity Health (Bakersfield, CA)
- …preferred. - Exposure to national platforms such as Innovaccer , Epic Payer Platform, or similar systems preferred. - Masters degree in Business Administration, ... Healthcare Administration, Computer Science, or related field preferred. **Overview** The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric, full-service management service… more
- Centene Corporation (Sacramento, CA)
- …activities to ensure compliance with current state, federal, and third-party payer regulations + Provides feedback to leadership on opportunities to improve ... and enhance care and quality delivery for members in a cost-effective manner + Other duties or responsibilities as assigned by people leader to meet business needs + Performs other duties as assigned + Complies with all policies and standards… more
- Alameda Health System (Oakland, CA)
- …to assign diagnosis codes, assigns CPT codes, and applies knowledge of payer reimbursement guidelines to ensure proper reimbursement. Performs related duties as ... required. **DUTIES & ESSENTIAL JOB FUNCTIONS:** NOTE:The following are the duties performed by employees in this classification, however, employees may perform other related duties at an equivalent level. Not all duties listed are necessarily performed by each… more
- Dignity Health (Los Angeles, CA)
- …(ACM-RN), or UM Certification preferred + Knowledge of managed care and payer environment preferred. This position is represented by CNA. **Overview** Founded in ... 1887, Dignity Health - California Hospital Medical Center is a 318-bed, acute care, nonprofit hospital located in downtown Los Angeles. The hospital offers a full complement of services including a Level II trauma center, the Los Angeles Center for Womens… more
- Boehringer Ingelheim (Palm Springs, CA)
- …ILD territory business needs and actively involves Associate Director, Clinical Educator, Payer Relations Managers, and other BI Internal support personnel in the ... development, management and accomplishment of business strategies, plans and opportunities. + Analyzes territory information to optimize ILD HCP calls. Monitors and effectively reacts to local market conditions for changes that impact business. + Develops… more
- Dignity Health (Merced, CA)
- …of the point of sale machine. + Verifying identity and signatures of the payer prior to purchasing services. + Job incumbents may be asked to perform other ... duties. **Qualifications** **Minimum** + Must possess and maintain a current Registered Nurse License with the state of California. + Current valid California Drivers License. + Demonstrated ability to apply theories of adult education and teaching methods. +… more
- Alameda Health System (Oakland, CA)
- …including InterQual(R) criteria methodology, resource management, medical necessity guidelines, payer sources, clinical outcome metrics, length of stay initiatives, ... readmission strategies, reimbursement rules and medical record documentation requirements. + Serves as Content Expert/Liaison to community agencies, AHS and Non AHS primary care provider network and all AHS stakeholders across all AHS facilities (ie Nursing… more
- Cedars-Sinai (CA)
- …analyzes, and reports on healthcare contracts (eg, physician agreements, payer contracts) to assess financial performance, revenue generation, and profitability. ... Analyzes managed care contracts for compliance and financial performance, identifying areas for optimization. **Qualifications** **Education:** BA/BS in Finance, Accounting, Healthcare Management or related field of study required. Master's degree preferred.… more
- ThermoFisher Scientific (Carlsbad, CA)
- …delivery systems and a strong understanding of healthcare finance/accounting and provider/ payer economics + Outstanding interpersonal skills and proven ability to ... work effectively and in matrix environment with multiple team members + Strategic selling and complex selling skills + Significant drive for results + Ability to lead without authority to achieve desired sales results + Strong project management skills with… more
- Datavant (Sacramento, CA)
- …Ensure products are clinically relevant, user-centric, and integrated into existing payer and provider workflows through interoperability integrations. + Set and ... track KPIs for each product line, such as suspect accuracy, provider engagement, risk score impact, and concurrent coding capture and correction rates. + Establish and track KPIs that measure both risk adjustment performance and interoperability success (data… more