- Pairtu (San Francisco, CA)
- …We're looking for a senior, hands-on operator who can work across credentialing, payer contracting, provider onboarding, and day-to-day ops while keeping a sharp eye ... need structure and predictability or 'need to be a manager ' this isn't for you. The upside? You'll level...Own Credentialing & Compliance Workflows** - Manage provider credentialing, payer enrollment, and ongoing compliance. - Keep every contract,… more
- Cognizant (Sacramento, CA)
- **Health Payer Business Analyst, Senior Consulting Manager ** **About the Role:** As a Sr. Consulting Manager you will make an impact by driving client ... projects and digital transformation initiatives * Deep understanding of payer functions and Medicaid plan implementations, including enrollment, billing, claims,… more
- Merck (Sacramento, CA)
- **Job Description** Field Access Manager The Field Access Manager (FAM) serves as the subject-matter expert on access related issues for healthcare professionals ... with internal stakeholders to support seamless patient access to therapy * Monitor payer trends to address access barriers * Provide access information to HCP… more
- J&J Family of Companies (Fresno, CA)
- …Posting Locations:** Fresno, California, United States **Job Description:** **Field Reimbursement Manager (Immunology Rheumatology) - Fresno, CA - Johnson & Johnson ... Solutions (PECS) team is recruiting for a Field Reimbursement Manager which will be a field-based position that will...the presence or absence of support networks, provider and payer dynamics, and socioeconomic factors. For many patients, the… more
- Danaher Corporation (Los Angeles, CA)
- …which makes everything possible. The Senior Field Reimbursement Manager (US REMOTE) position is a provider / customer ... facing role responsible for delivering compliant payer coverage, coding and reimbursement information regarding Cepheid on market diagnostics. This role will cross… more
- Providence (Anaheim, CA)
- **Description** Manager Pharmacy Business - Home Infusion - St. Joseph Health System Home Care Services - Anaheim, CA Schedule- Full Time/ Days The Pharmacy Business ... Manager provides leadership and oversight of business operations supporting...benefits investigation, prior authorizations, delivery ticket accuracy; evaluating new payer contracts; payer contract compliance; vendor and… more
- Cardinal Health (Sacramento, CA)
- ** Manager , Revenue Cycle Manager , Collections** **About Navista** We believe in the power of community oncology to support patients through their cancer ... with a strong emphasis on oncology practice needs. **_Job Purpose:_** The Manager , Revenue Cycle Management, is responsible for overseeing the insurance collection… more
- Cedars-Sinai (Los Angeles, CA)
- …Medicare Short Stay cases and assists with real-time management of concurrent payer denials. + This role ensures timely, accurate, and compliant clinical validation ... in accordance with CMS requirements and payer timelines. The UM RN collaborates with physicians, revenue...14355 **Working Title** : Registered Nurse -Utilization Review Case Manager - 8 Hour Days **Department** : Utilization Management… more
- University of Southern California (Arcadia, CA)
- …functions within this role include: facilitation of pre-certification and payer authorization processes, facilitation of the collaborative management of patient ... to facilitate covered day reimbursement certification for assigned patients. Discusses payer criteria and issues on a case-by-case basis with clinical staff… more
- Sharp HealthCare (San Diego, CA)
- …Day **FTE** 1 **Shift Start Time** **Shift End Time** Accredited Case Manager (ACM) - American Case Management Association (ACMA); Bachelor's Degree in Nursing; ... Master's Degree; Certified Case Manager (CCM) - Commission for Case Manager ...to healthcare team.Conduct daily concurrent reviews per protocol/policy and payer request.Utilize appropriate care guideline software to identify the… more
