- Amazon (Boston, MA)
- Description Amazon Pharmacy Payer Relations is seeking a driven, talented, and experienced to play a critical role in B2B Business Development working with large ... also driving member adoption of Amazon Pharmacy About the team Payer relations business development is part of Amazon Pharmacy Partener Services, representing… more
- Beth Israel Lahey Health (Boston, MA)
- …in Healthcare or Retail Pharmacy. Knowledge of prior-authorization workflows, payer relations , prescription claims adjudication, and general reimbursement ... procedures. Ability to develop strong relationships with diverse groups of professionals (physicians, nurses, administration, etc. Experience with computer systems required, including web based applications and some Microsoft Office applications which may… more
- Ophthalmic Consultants of Boston (Plymouth, MA)
- …including 3+ years in a director-level role + Expertise in billing operations, payer relations , call center leadership, and staff development + Deep ... understanding of coding standards (ICD-10, CPT, HCPCS) and insurance processes + Proficiency with EHR and PM systems like Epic, Athenahealth, eClinicalWorks, or NextGen + Strong communication and leadership skills to work across departments and with executive… more
- Beth Israel Lahey Health (Boston, MA)
- …in Healthcare or Retail Pharmacy. 4. Knowledge of prior-authorization workflows, payer relations , prescription claims adjudication, and general reimbursement ... procedures. 5. Ability to develop strong relationships with diverse groups of professionals (physicians, nurses, administration, etc. 6. Experience with computer systems required, including web based applications and some Microsoft Office applications which… more
- Humana (Boston, MA)
- …data reporting, performance improvement, physician engagement, informatics, network development, and contract/ payer relations . This design gives the Fellow the ... opportunity to build fundamental communication, analytic, and problem-solving skills as well as an understanding of the ACO environment and population health strategies. To complement on-the-job training, fellows are involved in Board and other administrative… more
- Cardinal Health (Boston, MA)
- …entire network of participating health plans + Cultivate and maintain on-going payer relationships and Medicaid enrollments. + Adhere to cyclical renewal, retrieval, ... and updates per profile + Work closely with third party vendors to identify data needs and execute updates when required + Report results and outcomes of network status to management at regular intervals + Respond to third party/managed care requests in a… more
- Sanofi Group (Cambridge, MA)
- …Regional Account Director will demonstrate strong relationships with Trade/Industry Relations , Medical and Pharmacy Directors (clinical and administrative), Case ... sales and sales leadership teams, to ensure consistent exchange of important payer insights and messaging. The Regional Account Director will provide periodic market… more
- Fallon Health (Worcester, MA)
- …related issues, including but not limited to Sales, Claims, Provider Relations , Communications, Appeals and Case Management. + Strictly observes the HIPPA ... five years' experience as a utilization nurse in a payer or facility setting highly preferred. + Discharge planning...active participant in Clinical Rounds + Experience in a payer setting, managed care preferred. + Excellent verbal and… more
- OptiMindHealth (Quincy, MA)
- …and/or breakdowns that would be critically important to long term referral relations and recommend solutions to OptiMindHealth's Director of Physician Relations , ... 2. Understanding of the practice of medicine including referral relationships, payer requirements and other economic and clinical influences. 3. Experience and… more
- Sevita (Dedham, MA)
- …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