- Astellas Pharma (New York, NY)
- …expert for compliant access and reimbursement topics. With expertise in payer coverage, healthcare payment models, and utilization management criteria (ie Prior ... partnership with internal matrix teams (including Sales, Key Account Management, and Payer Account Management) to create and regularly update Account Business Plans… more
- Stony Brook University (Stony Brook, NY)
- …revenue generation and maintain compliance with State, Federal and third party payer regulations and requirements across the health system. This position provides ... reimbursement methodologies. + Knowledge of other governmental and third party payer reimbursement methodologies. + Proficiency in the use of Craneware Active… more
- Guthrie (Binghamton, NY)
- …an acute care setting with strong care management, utilization review, and payer knowledge. A Case Management certification or obtain a Case Management certification ... focal point for communication for healthcare team members, patient, provider, and payer . b) Supports development, integration, and monitoring It is understood that… more
- Merck (Albany, NY)
- …targeting and business analysis. + Articulates the complexities of the HIV payer environment, recognizing the role each stakeholder plays in the ability to ... and build partnerships with key stakeholders/departments. + Experience with complex payer environments, recognizing the role each stakeholder plays in the ability… more
- Datavant (Albany, NY)
- …to noisy or incomplete inputs. You'll own the Matching roadmap for our Payer vertical, while also shaping the broader strategy and uncovering needs across other ... + Familiarity with healthcare data, with bonus points for experience in the payer risk adjustment space + Deep comfort working with engineering and analytics teams… more
- Northwell Health (Staten Island, NY)
- …to the health care team regarding quality, utilization of clinical resources, payer , and reimbursement issues. + Works with on-site screeners in transitioning ... clinical course. + Ensures compliance with current state, federal, and third party payer regulations. + Identifies patients for Alternate Level Care (ALC) care list… more
- IQVIA (New York, NY)
- …+ Identify and cultivate relationships with national, regional and local KOLs, payer opinion leaders, formulary decision makers in practice to discuss therapeutic ... HCPs. + Deliver against engagement plans for key decision makers and payer -accounts by managing in collaboration with client field-based and non-field- based… more
- Arnot Health (Elmira, NY)
- …Health. Identify, track and trend, record and collect patient accounts denied by payer . Under the direction of the System Director of Care Coordination coordinates ... payers obtained from correspondence and or payments. Assists in tracking/trending by payer for denial reason items such as prior authorization, untimely filing,… more
- WMCHealth (Warwick, NY)
- …payers (Workers' Compensation, auto/liability, foundations, and any other specialty payer ). Qualifications/Requirements: One year of experience in hospital billing ... of collections management. Understanding of reimbursement methodologies, terms and payer billing requirements. Education: A high school or equivalency diploma… more
- CenterWell (Albany, NY)
- …leaders and champions to identify HEDIS gaps and deficiencies. + Participate in Payer calls/chart reviews. + Compile payer findings and assist with research. ... + Participate in payor meetings/discussions to ensure accurate data submission. **Use your skills to make an impact** **Required Qualifications:** + A minimum of three years Medical Coding experience or similar (including IPA and Offshore coding management) +… more