- Ellis Medicine (Schenectady, NY)
- …and/or linkage to community resources, medical insurance coverage - Medicaid, managed care /dual-eligible parameters; etc. + Actively assists and facilitates ... and federal regulations to ensure most appropriate level of care to conserve patient, payer and hospital...+ Tracks inappropriate admissions and escalates cases to the Director to facilitate process improvements and/or education. + Performs… more
- J&J Family of Companies (Titusville, NJ)
- …Pharmaceutical portfolio. External customers can include, but are not limited to, Managed Care Organizations (MCOs), large physician groups, Group Purchasing ... Scientific Account Lead, V&ESE Field** **Reports to: Regional Field Director , V&ESE Field** **Department/Division: Value & Evidence Scientific Engagement/Scientific… more
- Takeda Pharmaceuticals (Cincinnati, OH)
- …of the PI Sales Team, you will report to the Sr. Regional Business Director . **How you will contribute:** + Achieve sales quotas through driving new patient starts, ... healthcare professionals (Allergy/Immunology, Pulmonology, Infectious Disease, select Internal Medicine/Primary Care ). Educate and inform the HCPs on Takeda brands… more
- HCA Healthcare (San Antonio, TX)
- …and maintaining ongoing business relationships with key customers such as physicians, managed care payer organizations, medical supply companies, healthcare ... auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. + Free counseling… more
- Guthrie (Corning, NY)
- …c) Maintains a positive and professional relationship with payers that supports continued managed care contracts. d) Articulates the primary objectives of ... most appropriate cost. a) Works closely with the Medical Director and other members of the healthcare team to...for communication for healthcare team members, patient, provider, and payer . b) Maintains accountability for coordination of care… more
- Cognizant (Phoenix, AZ)
- …Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience in health ... management and managing clinical denials from Providers to the Health Plan/ Payer . The comprehensive process includes analyzing, reviewing, and processing medical… more
- AbbVie (Mettawa, IL)
- …Reviews 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
- Rush University Medical Center (Chicago, IL)
- …with strong time management skills. **Responsibilities:** 1. Writes standard appeal letters to Managed Care payers and submit charts when needed with these ... understanding of medical policies and applies them to current denial situations. Attends payer meetings as needed. 3. Contacts physician offices and works with their… more
- Prime Healthcare (Ontario, CA)
- …Specialist is also responsible for accurate and timely payment analysis of managed care contracts to determine that appropriate reimbursement is received. ... to insure that procedures and charges are coded in compliance with all payer guidelines and state/federal regulations, when assigned. Under the supervision of the … more