- Sanofi Group (Los Angeles, CA)
- …contribute to special projects focused on enhancing Market Access operations (eg, payer onboarding, hub integration, channel expansion) + Maximize digital tools with ... Trade & Channel, or Commercial Operations. + Deep operational knowledge of US payer systems, PBMs, GPOs, and specialty pharmacy distribution. + Proven track record… more
- Abbott (Livermore, CA)
- …+ Ensure all revenue cycle activities comply with federal, state, and payer regulations, including HIPAA and other applicable standards in cash transactions. + ... payment review processes, oversee compliance with insurance payment regulations and payer requirements. + Support organizational audits and financial reviews while… more
- Humana (Sacramento, CA)
- …targeted action plans. + Customize strategies to align clinical programs with payer -specific needs (MA, D-SNP). + Provide clinical input into network development, ... + years in managed care industry, either provider or payer . + Thorough knowledge of health care utilization and...geographic boundaries **Preferred:** + Experience in both provider and payer roles + Prior executive level role with successful… more
- Cognizant (Sacramento, CA)
- …TypeScript and Adobe AEM to drive innovative solutions in the Provider and Payer domains. This work-from-home position offers a day shift schedule allowing you to ... scalable solutions that meet the needs of Provider and Payer domains. + Ensure code quality and maintainability by...+ Have a deep understanding of the Provider and Payer domains with experience in developing solutions tailored to… more
- Abbott (Alameda, CA)
- …scientific soundness of activities, and ensure outcomes aligned with Global and regional payer needs. They will partner with a worldwide community of well recognized ... total ADC responsibility for numerous facets of global reimbursement & payer engagement. + TRAVEL: Approximately 25% **Experience You'll Bring** **Required** +… more
- Abbott (Alameda, CA)
- …and model scenarios for impacts/risks/opportunities of proposed government legislation, payer and environmental changes + Work cross functionally with Forecasting, ... Finance, and Commercial Teams to project and monitoring payer mix and net prices + Develop financial modeling, including pricing model upkeep and improvement +… more
- Abbott (Livermore, CA)
- …practices, with a focus on optimizing revenue cycle performance, enhancing payer -provider alignment, and supporting patient satisfaction. The ideal candidate brings ... in healthcare billing, coding standards (ICD-10, CPT, HCPCS), and payer regulations, along with strong leadership and cross-functional collaboration skills.… more
- Cardinal Health (Sacramento, CA)
- …practice. Managed Care oversees the interactions that take place between payer and provider(s) to ensure optimal reimbursement including managed care contracting, ... credentialing, and any other activity as it relates to payer interaction. Manager of Payor Contracting is responsible for...using knowledge of market, local and national benchmarks, and payer market. Key member of negotiating team for company.… more
- Ventura County (Ventura, CA)
- …with pre-visit planning and confirms appointments; + Enters and updates demographic and payer data in practice management system (ie Cerner); + Verifies coverage and ... payer eligibility, which may include programs, private insurances, and Medi-Cal. Performs financial screenings for program eligibility. Requests pre-authorizations… more
- CVS Health (Sacramento, CA)
- …**Preferred Qualifications** + Experience leading complex initiatives within the payer clinical space is preferred + Experience identifying value opportunities ... risk management, product strategy, regulatory policy + Broad understanding of the payer landscape with ability to synthesize multiple disparate data points into a… more