- Sumitomo Pharma (Austin, TX)
- …design direction for patient support programs + Experience in reimbursement and payer pull through + Experience implementing distribution channels and managing Sales ... Operations and distributor operations for cell & gene therapy products. + Experience managing multiple patient service/reimbursement/co-pay vendors + Recent rare disease product launch experience desired + Strong track record of cross functional leadership +… more
- Evolent (Austin, TX)
- …5 years of professional experience in claims-based healthcare analytics with a payer , provider, vendor, managed care, or related healthcare consulting entity + ... Extensive knowledge of healthcare claims; specifically, differences between institutional vs professional billing and various sites of care/service + Previous Experience with healthcare reimbursement methodologies and calculations such as DRGs, Revenue Codes,… more
- Highmark Health (Austin, TX)
- …combination of experience and education **Preferred** + 6 years of experience in payer , hospital system, or care delivery industry + Experience influencing change in ... complex organizational systems **SKILLS** + Ability to solve complex conceptual and operational problems; potential ability to lead teams in problem-solving exercises + Strong quantitative and analytical skills + Demonstrated influencing, and teamwork skills +… more
- Evolent (Austin, TX)
- …opportunity sizing. **Healthcare Industry Experience:** Familiarity with clinical workflows, payer operations, or healthcare AI applications is preferred. **Why Join ... Us?** Opportunity to drive impactful AI initiatives in a rapidly evolving industry. Collaborative environment with cross-functional teams, including data science, engineering, and operations. Competitive compensation, benefits, and opportunities for… more
- ChenMed (Houston, TX)
- …+ Prescribes medication and treatment in accordance with patient condition, payer coverage/guidelines and industry standards. + Reviews PCP requests for external ... cardiology referrals and participates in delegated utilization authorizations; determines level of urgency of follow-up, referral/consultation appointments. + May have responsibility for cardiology clinical operations of 2-4 centers in the market, under the… more
- Highmark Health (Austin, TX)
- …control frameworks, and assessment methodologies, particularly as applied to healthcare ( payer and provider) business processes. + Knowledge of relevant regulatory ... guidelines, vendor management, sourcing and procurement, and completing assessments of vendors + Excellent resource and project planning capabilities, decision making skills, history of results-oriented delivery, and effective team building across a… more
- Methodist Health System (Dallas, TX)
- …and physician services; and ensuring that necessary communication occurs between the payer , and MMC for appropriate and accurate billing and reimbursement of ... services. It also includes the social worker role of assisting patients who have complex psychosocial needs, who require assistance with eligibility determination for social programs and funding sources and qualify for community assistance from a variety of… more
- Prime Therapeutics (Austin, TX)
- …and relationship management abilities + Knowledge of healthcare regulations, payer strategies, and compliance requirements + Proficient in Microsoft products, ... including excel and powerpoint + Ability to manage complex projects across the enterprise through cross-collaboration **Preferred Qualifications** + Master's degree in Business Administration or Public Health or Oncology Pharmacy Specialty Certification BCOP… more
- Chiesi (Dallas, TX)
- …a cross-functional team to ensure the marketplace understands clinical data, payer access information and company resources to support prescribing, initiation, and ... continuity of therapy for patients. The KAM role is paramount to Chiesi's future success as we strive to become a leading, global rare disease company. This role requires a unique set of skills that demands excellent customer engagement & communication skills,… more
- San Antonio Behavioral Health (San Antonio, TX)
- …Word and Excel. + Has knowledge of governmental and managed care payer requirements. + Demonstrates understanding of the various "Self-Pay" account classifications ... and their applicable patient statement processes. + Understands the data elements required to generate a clean bill. + Understands the importance of maintaining confidentiality; able to maintain confidentiality under HIPAA standards. + Must have the ability to… more