- Highmark Health (Pittsburgh, PA)
- …clearly differentiate Highmark's enGen platform. Tailor messaging to resonate with payer , provider, and hybrid organizations. + Sales Enablement & Knowledge Sharing: ... years of experience with strong understanding of US healthcare ecosystem - payer (Medicare Advantage, Stars, UM/CM), provider (EHRs, VBC, population health), or life… more
- Cognizant (Harrisburg, PA)
- …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
- Guthrie (Sayre, PA)
- …Medicare/Medicaid regulations, Medicare Advantage UM rules/regulations, and Commercial payer rules/regulations regarding medical necessity, patient types, etc. Must ... be able to provide evidence of knowledge in and experience of payer contract language, as it relates to utilization management. Can navigate through the requirements… more
- Cardinal Health (Harrisburg, PA)
- …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
- CSL Behring (King Of Prussia, PA)
- …Specialty Pharmacies, and distributors for all CSL therapies. Works with payer and channel Customer Account Managers in educating and resolving reimbursement ... for any new products and procedures. + Work with payer and channel Customer Account Managers in educating and...(Specialty Pharmacy) accounts and attend customer account calls with payer and channel CAMs as needed to present reimbursement… more
- Cardinal Health (Harrisburg, PA)
- …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 ... timely manner. The Coordinator, Individualized mediates effective resolution for complex payer /pharmacy issues toward a positive outcome and provides a positive… more
- CVS Health (Monroeville, PA)
- …and resolves any issues. + Maintain primary responsibility for resolving all payer /client issues while leading discussions with Payers, Sales and Legal. + Assure ... compliance with all regulatory, payer , and Government directed programs within the A/R area. + Advance the adoption of automation, AI, and strategic solutions to… more
- Option Care Health (Harrisburg, PA)
- …Summary:** Responsible for the timely, accurate submission of invoices to responsible payer , of any type, for all services and products provided. Evaluates payments ... **Job Description:** Job Responsibilities: + Submits timely, accurate invoices to payer for products and services provided. Understands the terms and fee schedule… more
- Genesis Healthcare (Quakertown, PA)
- …is responsible for achieving organizational goals related to patient census and payer management. This role maintains and expands the patient referral source list, ... response times of less than 15 minutes, and achieving budgeted census and payer goals. *Build and nurture relationships with key referral sources in the community… more
- Pfizer (Collegeville, PA)
- …expert. The Sr. Manager will partner closely with brand teams, USMA Payer Brand Marketers, Patient Services, SPP Strategy, BU Patient Solutions, legal, compliance, ... Strong financial competence and analytical skills + Experience in marketing, payer marketing, specialty pharmacy, strategic and tactical planning, and business… more