- UCLA Health (Los Angeles, CA)
- …role, you will: + Manage an assigned portfolio of accounts across payer types, executing complex claim reviews, resolving payment delays, and optimizing collections ... and rebill claims as needed, ensuring compliance with contract terms and payer policies + Maintain thorough documentation in CareConnect and ensure workflows are… more
- Open Mind Health (CA)
- …supervision but with ongoing monitoring. + Has worked with a variety of payer portals including Aetna, Blue Cross Blue Shield, Optum, United, Kaiser Permanente, and ... confirming appointment dates and times. + Has deep understanding of assigned payer expectations, practices and policies to ensure smooth operations and high… more
- Grifols Shared Services North America, Inc (Calexico, CA)
- …business review analytics that effectively measure, track, and quantify changes payer /brand business segment, and competitor business patterns + Monitor and analyze ... industry, payer and customer trends, competitor pricing, and market conditions;...Skills & Abilities:** + Deep understanding of the US payer and market access environment and reimbursement methodologies +… more
- Providence (Burbank, CA)
- …insurance benefits investigation, prior authorizations, delivery ticket accuracy; evaluating new payer contracts; payer contract compliance; vendor and payer ... contract tracking; accounts payable process; customer service and reception; office supply management; telephone switchboard management; assuring key business documents including licenses, registrations, permits, and certifications are current and up to date;… more
- Novo Nordisk (San Mateo, CA)
- …basis with territory level impact + Demonstrates understanding of the local payer market including Medicare, Commercial and Medicaid benefit designs, Payer ... gain commitment to utilize NNI products for appropriate patient types utilizing payer opportunities, brand/sales strategies and objectives in order to meet territory… more
- Cardinal Health (Sacramento, CA)
- …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 ... a timely manner + Mediate effective resolution for complex payer /pharmacy issues toward a positive outcome to de-escalate +...appropriate sections of the database + Must track any payer /plan issues and report any changes, updates, or trends… more
- Blue Matter (San Francisco, CA)
- …raw data analysis (MMIT, IQVIA, etc.) + Development of Budget Impact Models ( payer / provider) in support of core strategy initiatives + Development of traditional ... wastage penalties, drug pricing caps, etc.) + Development of payer / provider contract strategy simulation models + Inpatient...core 3rd party data sets involving provider unit data, payer access data, analog sales data, etc. + Ability… more
- NTT DATA North America (San Francisco, CA)
- …seeking a **Senior Sales Executive with IT services sales experience in the Healthcare Payer domain** to join our team in San Francisco, CA. This is a remote ... Services/Professional Services** space and strong relationships in the **Health Plan/ Payer ** industry. Additionally, a deep understanding of Information Technology… more
- Edwards Lifesciences (Irvine, CA)
- …to TMTT therapies by generating key evidence to support private and public payer coverage decisions + Collaborate with internal teams, particularly the TMTT GHER ... evidence generation to business objectives, enabling alignment across product development, payer engagement, and policy planning. + Partner with external experts to… more
- Cardinal Health (Fresno, CA)
- …+ Organize and prioritize tasks across multiple practices, adapting to dynamic payer requirements and operational needs. + Provide guidance, coaching, and mentorship ... opportunities. + Research CPT code denials against LCD/NCD requirements and payer policies. + Collaborate with cross-functional teams to implement clean claim… more