- Kaleida Health (Buffalo, NY)
- …outlook required. 8 years of experience in multi- hospital system and / or managed care required. 10 years of experience in Federal, state and accreditation ... ** Director Clinical and DRG Denials** **Location:** Larkin Bldg...methodologies, coverage issues, documentation, coding conventions and insurance / managed care practices including but not limited… more
- Aspen Dental (Albany, NY)
- …This role will play a key part in supporting our managed care operations and strategic payor initiatives. The Director will ensure data accuracy, ... created an opportunity to join our team as a Director , Data Management. Aspen Dental is seeking a highly...data extraction, transformation, and analysis. + Deep understanding of managed care operations, including provider and facility… more
- Takeda Pharmaceuticals (Boston, MA)
- …specialty pharmacy, etc.) + Understanding of US payer market dynamics and how managed care organizations make decisions across commercial and public channels + ... is true to the best of my knowledge. **Job Description** Join Takeda as a Director , Market Access and Channel Strategy within US Patient and Market Access (PAMA) out… more
- Molina Healthcare (Santa Fe, NM)
- …guidelines. + Experience in Utilization/Quality Program management + HMO/ Managed care experience **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** ... includes strategies that ensure a high quality of patient care , ensuring that patients receive the most appropriate ...(QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to… more
- Weill Cornell Medical College (New York, NY)
- …cost-benefit analyses for proposed research initiatives and investments as well as managed care contracting negotiations with NewYork-Presbyterian. Present ... Title: Director , Research Finance & Analysis Location: Midtown Org...medical center that is committed to excellence in patient care , scientific discovery, and the education of future physicians… more
- Highmark Health (Baton Rouge, LA)
- …Insurance, Consulting or related area + 3 years Value-based reimbursement, through managed care contracting , provider reimbursement, consulting, population ... drive adoption and ROI realization. Critical partners include Advanced Analytics, Contracting , Market and Provider support teams, Actuary, Finance, Highmark Health… more
- UTMB Health (Galveston, TX)
- …pay or regulatory requirements. + Thorough knowledge of Hospital reimbursement and managed care contract issues. + Knowledge of automated systems that ... Director of Hospital Accounts Receivable **Galveston, Texas, United...of management and operational staff. + Works closely with contracting to ensure optimal payer contract terms and is… more
- The Cigna Group (Bloomfield, CT)
- …industry, with specific experience in managing clinical quality initiatives in a managed care setting. + Clinical design experience strongly preferred. + ... of the organization including but not limited to: Clinical Operations, Contracting , Data Interoperability, IT, Digital Solutions, Legal/Compliance, Care … more
- Trinity Health (Des Moines, IA)
- …and ongoing review and monitoring of contracts with third party payors and managed care entities. + Maintains functional accountability to the Trinity Health ... **Employment Type:** Full time **Shift:** **Description:** **POSITION PURPOSE** The Regional Director of Reimbursement serves as the primary contact to the Regional… more
- Molina Healthcare (Madison, WI)
- …+ 10+ years relevant experience, including 5+ years of clinical practice and 3+ years HMO/ Managed Care experience **OR** 5 years experience as a Molina Medical ... inpatient concurrent review, discharge planning, case management and interdisciplinary care team activities. + Ensures that authorization decisions are...Director + Demonstrated experience in Utilization/Quality Program management +… more