- City of New York (New York, NY)
- …of public and commercial payors at the federal and state levels, and the evolution of managed care - Value-based care and Alternative Payment Models - Price ... and healthcare systems in partnership with community, faith-based, and health care organizations. CHECW's work focuses on social determinants of health, including… more
- Integra Partners (Troy, MI)
- …+ Maintaining expected timelines EXPERIENCE: + 1 year as a UM Coordinator in a managed care payer environment preferred + Knowledge of ICD-10, HCPCS codes ... UM Coordinator assists and supports the clinical team (UM Nurses/Medical Director ) with administrative and non-clinical tasks related to processing Utilization… more
- 32BJ Benefit Funds (New York, NY)
- …healthcare or health benefits environment + Prior knowledge of healthcare regulations, payer /provider dynamics, and valued-based care models preferred + Internal ... Code G2825HF Department Name Health Fund Admin Reports To Director , Chief of Staff FLSA Status Exempt Union Code...processes that guide how work is prioritized, resourced, and managed across the Health Fund. This individual will play… more
- WMCHealth (Valhalla, NY)
- …within the outside the hospital as necessary (especially admitting, billing office, fiscal, managed care , insurance case managers, finance) and the screeners. + ... Services PC City/State: Valhalla, NY Category: Clerical/Administrative Support Department: Clinical Care Mgmt- WMC Health Union: No Position: Full Time Hours: M-F… more
- Trinity Health (Westchester, IL)
- …with other hospital departments such as Patient Access, Coding, Case Management, and Managed Care to gather necessary information and ensure claims are processed ... of Trinity Health, is a nationally ranked academic, quaternary care system based in Chicago's western suburbs. With its...collection follow-up based on the specific issue with the payer and required actions. + Recommend accounts for agency… more
- Prime Healthcare (Anaheim, CA)
- …Specialist is also responsible for accurate and timely payment analysis of managed care contracts to determine that appropriate reimbursement is received. ... Founded in 1964, West Anaheim Medical Center is a 219-bed acute- care hospital dedicated to providing the community with high-quality, compassionate healthcare.… more
- Cognizant (Annapolis, MD)
- …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
- Emory Healthcare/Emory University (Atlanta, GA)
- …professional billing denials across the healthcare system. + Reporting to the Director of Enterprise Denial Management, this role provides critical insights into ... Ensure all denial management activities comply with federal, state, and payer -specific regulations. + Cross Functional Collaboration: + Work closely with departments… more
- Takeda Pharmaceuticals (Boston, MA)
- …as well as scientific, medical and clinical oversight in support of medical, payer and patient access strategies for all Oncology products and pipeline + Lead ... partnerships with the corresponding global and US business Unit and the Managed Market Organizations + Form integrated partnerships with R&D therapeutic area(s),… more
- PruittHealth (Norcross, GA)
- …all services and facilities within PruittHealth. **WORKING RELATIONSHIPS:** Directly Reports to: Director of Managed Care Contracts **ESSENTIAL JOB ... educate on the requirements of credentialing and re-credentialing. * Support the Payer Relations with reports and updates regarding participation status with all… more