- Amazon (Austin, TX)
- 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
- Houston Methodist (Houston, TX)
- …Care Contracting position is responsible for the development, negotiation, maintenance and payer relations of the Houston Methodist (HM) contracts for ... pricing, rate structures, addendums, and language requirements. + Analyzes and manages payer quality metric bonus and risk programs in conjunction with internal… more
- University of Texas Rio Grande Valley (Edinburg, TX)
- …experience. Preferred Experience Involvement with managed care contract negotiation and payer relations . Familiarity with healthcare financial systems and ... electronic medical record ( EMR ) platforms is highly desirable. Proficiency with financial analytics software (eg, Tableau, Power BI) or hospital information systems (eg, MEDITECH , Cerner, EPIC ). Knowledge of healthcare grants and alternative payment models… more
- Humana (Austin, TX)
- …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 (Austin, TX)
- …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
- Caris Life Sciences (Irving, TX)
- …payor relations and contracting teams to ensure alignment between payer policies and authorization protocols. + Identify and implement technology solutions and ... process, including benefit investigations, prior authorizations, financial clearance, and payer -specific requirements. This leader will work cross-functionally with clinical… more
- UTMB Health (Galveston, TX)
- …compliance with federal and state regulations. This role will oversee payer relationships, evaluate financial and operational performance of contracts, and ... to support strategic initiatives related to revenue cycle, provider relations , and population health management. **EDUCATION & EXPERIENCE** **Minimum… more
- HCA Healthcare (Dallas, TX)
- …structure that successfully supports performance with accountable care organizations, CMS programs, payer specific quality programs and other quality, payer , and ... LCSW Care Managers, Care Coordinators + Maintains comprehensive knowledge of payer and regulatory requirements with ability to work effectively under pressure… more
- Methodist Health System (Dallas, TX)
- …+ Investigate and address claim denials promptly. Utilize knowledge of payer policies, medical coding guidelines, and billing regulations to appeal denials ... including explanation of benefits (EOBs), remittance advice (RA), and other payer communications. Take necessary actions based on correspondence received, such as… more
- Methodist Health System (Richardson, TX)
- …* Be engaged and eager to build a winning team * Ability to interpret Payer Clinical Policies in reference to practice procedures. * Contacts Payer (s) in a ... employment opportunity to all people in all aspects of employer-employee relations without discrimination because of race, color, religion, national origin, age,… more