- Catholic Health Initiatives (Houston, TX)
- …successful reporting of revenue cycle AR Work with IT, Financial Data Warehouse, and Managed Care to develop dashboards and metrics tracking. Other duties as ... 1) developing/maintaining Key Performance Indicator (KPI) dashboards, reimbursement and payer mix analyses and clinic/business operational reports; 2) interpreting/explaining… more
- Covenant Health Inc. (Knoxville, TN)
- …Covenant Health Overview: Covenant Medical Group is Covenant Health's employed and managed medical practice organization, with more than 300 top Physicians and ... providers spanning the continuum of care in 20 cities throughout East Tennessee. Specialties include cardiology, cardiothoracic surgery, cardiovascular surgery,… more
- Eastern Connecticut Health Network (Manchester, CT)
- …Word processing and spreadsheet computer operations. Certain assignments may involve extensive managed care interface. This position contributes to creating a ... Experience in a related setting using medical/psychiatric terminology and working with managed care and Behavioral Health carve outs is preferred. COMPETENCIES:… more
- Beth Israel Lahey Health (Woburn, MA)
- …International Classification of Diseases (ICD-10) o reimbursement theories to include RBRVUS, MPFS, and managed care o NCCI edits and Medicare LCD/NCDs o health ... you're making a difference in people's lives.** Under the direction of the Director , Revenue Integrity and Coding at Harvard Medical Faculty Physicians (HMFP) at the… more
- AbbVie (Mettawa, IL)
- …analysis. Ad hoc + Prepare various analytics across the Immunology portfolio (KAM package, Managed Care & Medicare payer rebates, SP Discounts, AAR ... lives across several key therapeutic areas - immunology, oncology, neuroscience, and eye care - and products and services in our Allergan Aesthetics portfolio. For… more
- HonorHealth (AZ)
- …accuracy and optimal reimbursement. + Attends JOC as requested by Utilization Management or Managed Care : Works with Director , Management and staff to ... Reviews concurrent denials and intervenes with attending and/or consulting physicians and managed care medical directors, as needed, for reconsideration and… more
- AmeriHealth Caritas (Washington, DC)
- …office setting. + Minimum of 2 years of utilization management experience in managed care preferred. + Proficiency in Electronic Medical Record Systems to ... policies. When necessary, cases are escalated to the Medical Director for further review. The reviewer independently applies medical...to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and… more
- Covenant Health Inc. (Knoxville, TN)
- …and intermediaries, knowledge of third party reimbursement with working knowledge of Network/ Managed Care issues, and a thorough understanding of collection and ... Assists other departments as needed and meets other requests of the Director and Vice-President of Financial Services. Recruiter: Suzie McGuinn || ###@covhlth.com… more
- Somatus (Nashville, TN)
- …years of program management experience or operational experience in population health, managed care , case management, or healthcare consulting, particularly in ... in Somatus care management and RenalIQ applications. . Supports the Director of Operations in tracking Somatus monthly, quarterly, and end of year Payor… more
- Tidelands Health (Murrells Inlet, SC)
- …of experience and/or knowledge of third-party payor regulations related to managed care , denials, and reimbursement issues required. **License/Certification** : ... and time management skills. + Knowledge of third-party payor regulations related to managed care , denials, and reimbursement issues + knowledge of Terminology… more