- CVS Health (Sacramento, CA)
- …with Compliance, Legal, Medicaid Health Plans, Network Contracting, and Provider Relations to ensure alignment with regulatory and contractual obligations. The Lead ... key liaison between Compliance, Legal, Network Contracting, and Provider Relations teams. **Required Qualifications** + A minimum of 7...Qualifications** + A minimum of 7 years of healthcare payer experience, with at least 5 years in provider… more
- HCA Healthcare (Riverside, CA)
- …services to facility-level physician credentialing, business development, and provider relations in contracting issues + You will provide medical consultation ... case managers and hospital staff in the reduction of payer denials and in the denial and appeals process,...patient safety, case management, medical staff affairs, and physician relations activities + You will promote consistent, positive patient… more
- Sevita (Fresno, CA)
- …and direct appropriate response; ensure timely incident reporting + Stakeholder Relations + Maintain and foster communication and relationships with individuals, ... other stakeholders; identify opportunities by following industry trends and responding to payer need + Direct program strategy to manage census, maintain occupancy,… more
- Evolent (Sacramento, CA)
- …client and organizational objectives. **What You Will Be Doing:** **Account/ Relations Management** - provide corporate, executive and overall account management for ... initiatives, strategies, and developing/managing performance scorecards and action plans ( payer , provider, initiative, etc.). + Ability to travel as needed… more
- Ventura County (Ventura, CA)
- …ICD-10 CM/PCS and CPT coding guidelines, Federal and State regulations and Payer -specific guidelines as required; + Oversees the Discharged Not Final Coded (DFNC) ... processing + electronic health records (EHR) systems + CDI program + public relations + personnel administration as applicable to allocated level and program +… more
- Sevita (Chico, CA)
- …and occupancy percentages; respond to local requests for proposals to address payer needs; identify and participate in new start development initiatives, and ... partners. + Implement regional strategies to maintain and foster relations with individuals receiving services, families, and guardians; oversee implementation… more
- Dignity Health (Bakersfield, CA)
- …insights. - Performs gain-sharing and risk-sharing calculations in accordance with payer contracts and criteria established by Dignity Health MSO senior leadership ... written and verbal communication, judgment, problem-solving, presentation and public relations . **Preferred Qualifications:** - Preferred seven (7) years of… more
- Highmark Health (Sacramento, CA)
- …both the return on investment (ROI) and other decisions on the payer partnership constructs. These new approaches require new operational capabilities, and this ... leaders. Serve as a subject matter expert working in concert with provider relations and clinical transformation consultants to explain new programs and results to… more
- Dignity Health (Bakersfield, CA)
- …agenda and presentation for Contacting Meetings. - Collaborates with Provider Relations , Compliance, and Health Plan Strategy to ensure aligned implementation. - ... - Minimum of eight (8) years of progressive experience in provider contracting, payer negotiations, managed care strategy - At least five (5) years in a… more
- US Tech Solutions (San Francisco, CA)
- …additional resources for patients/families and visitors when needed (ie: patient relations , spiritual care services, social work and community services). + ... Discharges, and Transfers (ADT) experience + Previous experience in hospital, insurance payer , or physician's office setting + Basic knowledge of Medical Terminology… more