- HCA Healthcare (Reston, VA)
- …onsite collections, familiar with Medicare guidelines/regulations, billing and collection techniques, managed care , coding and insurance carrier rules and ... auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. + Free counseling… more
- AmeriHealth Caritas (Washington, DC)
- …+ Experience conducting prior authorizations and/or concurrent reviews within a managed care organization preferred **Licensure** + Active and unencumbered ... 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
- 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
- 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
- Mount Sinai Health System (New York, NY)
- …they align with payer regulations, Medicare/Medicaid reimbursement methodologies, and managed care contracts. + Provides routine, standardized reporting to ... sets, Epic edits, and reimbursement. + Capacity to review, analyze and interpret managed care contracts, billing guidelines, and state and federal regulations… more
- 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: Scientific Affairs Value and Evidence Scientific… more
- Integra Partners (Troy, MI)
- … care setting. + Minimum 2 years of utilization management experience in a payer or managed care environment. + Strong understanding of utilization ... Review and process clinical and administrative appeals; coordinate with Medical Director when required. + Generate and review daily/weekly reporting on productivity… more
- Takeda Pharmaceuticals (IL)
- …PI Sales Team, you will report to the Sr. Regional Business Director . Territory includes Springfield, Peoria, Normal, Champaign, Naperville, Joliet, IL and Oakbrook ... healthcare professionals (Allergy/Immunology, Pulmonology, Infectious Disease, select Internal Medicine/Primary Care ). Educate and inform the HCPs on Takeda brands… more
- Dignity Health (Chandler, AZ)
- …and patient satisfaction outcomes. **Skills needed:** Knowledge of federal, state and managed care rules and regulations including CMS and AHCCCS. Working ... **Job Summary and Responsibilities** Under the general direction of the Director of Care Management, performs criteria-based concurrent and retrospective… more