- CVS Health (Albany, NY)
- …each and every day. **Position Summary** The Specialty Strategic Account Executive - Payer Relations manages a portfolio of small to mid-size regional health ... This role supports growth, retention, and profitability for the Specialty Pharmacy Payer Relations team by leveraging strategic client engagement, contract… more
- Northeast Family Services (Brooklyn, NY)
- …and innovative behavioral-health models. + Support contract negotiations and onboarding of new payer or referral partnerships. Payer Relations & Network ... to drive expansion in new and existing markets, strengthen payer and referral relationships, develop innovative service offerings, and...Strategy + Assess reimbursement environments and payer trends across states to inform growth strategy. +… more
- Cardinal Health (Albany, NY)
- **_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
- Catholic Health Services (Melville, NY)
- …to the patient in advance if an out-of-network status applies. + Ensure payer requirements including the following are met: + Verify and document insurance ... visit information to determine whether authorization is needed and understand payer specific criteria to appropriately secure authorization and clear the account… more
- Pfizer (New York, NY)
- …profitability, and go-to-market approaches, 2) unlocking new avenues for incremental profitable payer access in close partnership with USMA and the customer facing ... rights on pricing, contracting offers, and strategically balance trade-offs across provider, payer , GPO that will impact long-range forecast development + Sign off… more
- Ellis Medicine (Schenectady, NY)
- …communication (verbal, written and phone), interpersonal and positive customer relations skills required. + Certification: n/a RESPONSIBILITIES OF THE POSITION: ... meetings with all payers to continuously improve communications between provider and payer in order to resolve issues, reduce outstanding aged accounts, increase… more
- Rochester Regional Health (Rochester, NY)
- …data entry, and point-of-service collections, while maintaining patient relations , customer satisfaction, and Canton-Potsdam Hospital financial solvency. ... computer system reviewing for mandatory precertification and/or other third party payer requirements + Collects complete financial information to include payer… more
- Catholic Health Services (Melville, NY)
- …and that required clinical criteria is complete and accurate according to payer requirements. The role will work closely with Utilization Management, Patient ... DUTIES/RESPONSIBILITIES: + Determine whether authorization is required and utilize payer -specific requirements to secure authorization. + Submit prior authorization… more
- University of Rochester (Rochester, NY)
- …determine the reason the request was denied and prepares a response to the payer with necessary additional information. + If the denial management needs to involve ... or if physician-to-medical director conversation is needed for approval outside of the payer policy. + Documents all PAs in the appropriate location within the… more
- Movn Health (NY)
- …existing payer agreements. Qualifications + 5-8 years in provider relations , physician outreach, or healthcare sales, ideally in cardiology, chronic care, or ... existing accounts, drive referrals and renewals, and expand utilization under our national payer contracts. You'll own the revenue and net retention metrics for your… more