- CenterWell (Sacramento, CA)
- …billing operations with a focus on contract interpretation, validation, and payer setup. This role works collaboratively with internal departments, professional ... additional duties as assigned to meet departmental needs. **Key Responsibilities:** + ** Payer Setup:** Create and manage payer configurations, ensuring accuracy… more
- Open Mind Health (CA)
- LOCATION: REMOTE REPORTS TO: CLIENT LIAISON MANAGER ABOUT OPEN MIND HEALTH We are a collaborative team of mind-body-spirit experts who provide innovative, ... ongoing monitoring. + Has worked with a variety of payer portals including Aetna, Blue Cross Blue Shield, Optum,...+ Screen incoming calls, handle faxes, and keep the manager and key stakeholders informed. + Handle confidential client… more
- Cardinal Health (Sacramento, CA)
- …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 ... rethink how far their products can go. **_Responsibilities_** The Case Manager supports patient access to therapy through Reimbursement Support Services in… more
- Lilly (San Diego, CA)
- …and Value Proposition that addresses key customer needs (patient, provider, and payer ); the product lifecycle plan, clinical strategies, development plans and study ... by working closely with business unit, brand team, clinical plans manager /project management associates and other cross-functional management during the development… more
- University of Southern California (Alhambra, CA)
- …Edits charges on the claim form(s) or billing system for which departmental and payer guidelines stipulate should not be billed to the sponsor. Recomputes the total ... identified billing issues and trends to Supervisor and Billing Manager in a timely manner. Communicates issues with claim...charges correctly via patient accounting system. Updates case / payer data and documents the reason for the updates;… more
- CenterWell (Sacramento, CA)
- …identify educational opportunities. + Conduct research as needed. + Participate in Payer calls/chart reviews. + May participate in provider education programs on ... guidelines, healthcare regulations (including HIPAA, state and federal compliance), and payer requirements + Proficiency in Microsoft Office Suite (Word, Excel,… more
- Medtronic (Los Angeles, CA)
- …with cross-functional stakeholders including reimbursement, healthcare policy, marketing, payer marketing, medical affairs, and other functions. This position ... Evidence (RWE) studies including, epidemiology studies, registries, observational studies, payer pilots, cost-effectiveness modeling, surveys, and meta-analyses. + Collaborates… more
- John Muir Health (Walnut Creek, CA)
- …policies and processes. Serves as the business lead for all pharmacy payer contracts, ensuring appropriate access to commercial and government agreements. Pharmacy ... and healthcare reimbursement + Strong knowledge of outpatient pharmacy payer agreements and negotiation + Expert in data analysis...exempt (not eligible for overtime) under the level of Manager are listed as hourly for compensation purposes on… more
- Oracle (Sacramento, CA)
- …delivery through powerful, AI-driven workflow innovation. Our Autonomous Reimbursement, Payer , and Interoperability teams are developing advanced solutions to ... the Role:** We are seeking an accomplished Senior Principal Technical Program Manager (TPM) to lead and drive critical project reviews, security operation… more
- Cedars-Sinai (Beverly Hills, CA)
- …pharmacy analytics and reporting. Under the direction of the Pharmacy Manager , the coordinator applies data-driven methodologies to improve specialty pharmacy ... operations and monitor payer formulary and access changes. This position ensures compliance...quality and safety outcomes, engaging with external stakeholders regarding payer and limited distribution drug access, and managing data… more