- Waystar (Atlanta, GA)
- **ABOUT THIS POSITION** The Payer Relations Specialist is responsible for initiatives to identify and build contractual relationships with payers for direct data ... connections with those payers. As a key member of the Waystar payer relations team, the Payer Relations Specialist will drive new value for Waystar's… more
- Boehringer Ingelheim (Atlanta, GA)
- …an ILD territory business needs and actively involves Associate Director, Clinical Educator, Payer Relations Managers, and other BI Internal support personnel in ... the development, management and accomplishment of business strategies, plans and opportunities. + Analyzes territory information to optimize ILD HCP calls. Monitors and effectively reacts to local market conditions for changes that impact business. + Develops… more
- Cardinal Health (Atlanta, GA)
- **_What Network and Payor Relations contributes to Cardinal Health_** Marketing is responsible for assessing customer needs, market conditions and competition to ... and monitoring the appropriate products and services. Network and Payor Relations is responsible for the development and management of business relationships… more
- PruittHealth (Atlanta, GA)
- …Communicates written plan to Vice President of Program Development and Community Relations Development Coordinator. Monitor, evaluate and adjust the plan as needed. ... 21. Identifies case management, HMO, PPO, insurance companies and other payer referral sources. 22. Determines vulnerabilities of competitive relationships and set… more
- Highmark Health (Atlanta, GA)
- …the Medical Policy department, other internal departments (eg, Operations, Provider Relations , Clinical Programs), and external vendors to ensure seamless policy ... data + 5 years of project leadership in a complex, matrixed environment ( payer and/or provider preferred) + 5 years of providing analytical consultation to clinical,… more
- ChenMed (Atlanta, GA)
- …with healthcare network strategy, including network development, value-based care contracting, provider relations and local operations + Must be driven by a passion ... of innovative models of care delivery, strong understanding of the national payer and risk-bearing provider landscape, healthcare reform and population health trends… more
- Emory Healthcare/Emory University (Peachtree City, GA)
- …level of interaction with facilities and clients. Enhance and expand client relations with facilities and their staff. + Evaluate and develop patients' plans ... accurate documents of each patient's evaluation and progress letters to physicians and payer sources, case managers, etc. as indicated appropriately and in a timely… more
- Molina Healthcare (Augusta, GA)
- …resolution in line with policy and contractual guidelines. + Partner with provider relations , Health plans and appeals teams to address recurring dispute trends and ... provider disputes, appeals, and overpayment recoveries in a managed care or payer environment. + In-depth knowledge of medical and hospital claims processing,… more
- Highmark Health (Atlanta, GA)
- …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