- Centene Corporation (Tallahassee, FL)
- …Committee for Quality Assurance (NCQA) guidelines, state mandates, and/or government contract requirements. + Directs process improvements for clinical ... health and quality outcomes, improve care coordination, and meet requirements of contracts + Leads, develops, and ensures clinical initiatives and/or programs… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …of the SIU Management, this position is responsible for the accurate and thorough clinical investigation of potential fraud, waste and abuse (FWA) for all lines of ... substantiating referrals, case planning and research, conducting onsite or desk audits, clinical reviews of medical records to ensure correct billing of services and… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …programs and services. + Makes accurate and consistent interpretation of required clinical criteria, medical policy, contract benefits, and State and Federal ... Essential Accountabilities: Level I + Performs pre-service, concurrent and post-service clinical reviews to determine the appropriateness of services requested for… more
- University of Washington (Seattle, WA)
- …actions, layoffs and resolution of problems in partnership with their assistant clinical deans and the Vice Dean. + Administer and interpret University of ... and salary structures; serve as a resource on appointment types (affiliate, clinical , courtesy, etc.). + Prepare and coordinate faculty reappointment and promotion… more
- University of Colorado (Aurora, CO)
- …PIs + Assist the Vice Chair and Equipment committee with keeping service contracts up to date + Maintain detailed understanding of PI's current project portfolio ... etc + Maintain current files on all grant and contract awards + Financial data analysis and creation of...+ Maintain up to date files on all awarded/funded contracts and grants + Track monthly expenses and other… more
- University of Rochester (Rochester, NY)
- …- Develop and implement a successful business development program for new clinical trials business opportunities with Contract Research Organizations (CRO), ... Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 400071 Path&Lab Clinical Trials Work Shift: Range: UR URG 113 Compensation Range: $77,216.00 -… more
- University of Washington (Seattle, WA)
- …Department of Emergency Medicine (DEM) is responsible for the oversight and clinical care within three emergency departments within UW Medicine: Harborview Medical ... faculty and staff to facilitate the department's ability to achieve clinical , scientific, and educational goals. + Interprets policies and regulations concerning… more
- Novant Health (NC)
- …You'll Do The Director of Payer Strategy will lead payer accountability and manage contract performance and the defense audit team. This role is critical in ensuring ... implement strategies to maximize revenue from payers, including negotiating favorable contracts and identifying areas for improvement in reimbursement processes. .… more
- Otsuka America Pharmaceutical Inc. (Montgomery, AL)
- …as the primary operational point of contact for internal R&D stakeholders (GMA, Clinical ) and external HCPs regarding contract status, payment inquiries, and ... to engage external experts and is accountable for ensuring all contracts , payments, and documentation are processed efficiently, compliantly, and in accordance… more
- Community Health Systems (Antioch, TN)
- …preferred + 1-2 years of experience in healthcare collections, revenue cycle, or contract management required + Familiarity with payer contracts and healthcare ... revenue opportunities to recommend process improvements. + Evaluates and interprets contract reimbursement details, providing feedback and insights to the department… more