- Trinity Health (Des Moines, IA)
- …of applications for provider enrollment for Medicare, Railroad Medicare, BCBS, Medicaid, Managed Care payers, and applicable Commercial payers in a timely ... of denials. Collaboratively work with several different departments and payer contacts to ensure a timely submission of enrollment...directory of providers NPI log in and password. Complete Managed Care checklist. Supplies accurate and timely… more
- AdventHealth (Maitland, FL)
- …the analysis and evaluation of financial and economic data related to healthcare costs and managed care payer rates and reimbursement. The role focuses on ... able to complete extensive and complex financial, operational, and analysis of managed care contracts, proposals, analyze fee schedules, and determine contract… more
- Community Health Systems (Franklin, TN)
- …maximizing reimbursement by identifying variances between posted and expected revenue for managed care , government contracts, and other payers. This role ... analysis required **Knowledge, Skills and Abilities** + Strong understanding of managed care , government contracts, and reimbursement processes. + Proficiency… more
- Trinity Health (Caldwell, ID)
- …practices in the Saint Alphonsus Health Alliance under the supervision of the Executive Medical Director Value Care . Is an integral member of the health care ... Full time **Shift:** Day Shift **Description:** **CLINICAL PHARMACIST** **VALUE-BASED CARE ** Responsible for providing comprehensive medication management services for… more
- Houston Methodist (Katy, TX)
- …competency and professional pathway progression. + Communicates updates/changes to processes, managed care information, throughput, etc., in a timely manner. ... special projects after ongoing revenue cycle analysis. Meets with payors and/or Managed Care to discuss aged accounts, adjudications timeframes, and erroneous… more
- First Atlantic Health Care (South Portland, ME)
- …for various payer sources including, but not limited to, Medicare, MaineCare and Managed Care * Maintain daily census and mix goals per facility budget. * ... timely collection of clinical data relevant to the patient/resident's care , MDS completion and care plan development....the performance of all duties. * Report to the Director of Plant Operations or Supervisor any hazardous condition… more
- ChenMed (Houston, TX)
- …and linguistically diverse setting is essential + Experience working within a managed care environment strongly preferred We're ChenMed and we're transforming ... your kindness and joy? We're different than most primary care providers. We're rapidly expanding and we need great...the scope and member volume. + Assists the Medical Director , Cardiology in managing the day-to-day clinical and business… more
- Mount Sinai Health System (New York, NY)
- …pharmacy group. 11.Obtains prior authorizations from intermediaries and payers, including managed care companies, insurance companies or others as appropriate. ... **Job Description** Under direct supervision of the Director of Specialty Pharmacy, the Specialty Pharmacy Manager...years of retail pharmacy technician experience or related health care administrative, and a strong familiarity with the prior… more
- Trinity Health (Chelsea, MI)
- …for each patient while adhering to ethical practices per insurance guidelines for each payer . Works with site leader, director and/or secretarial staff to ensure ... adhering to ethical practices per insurance guidelines for each payer . + Works with site leader, director ...director and/or secretarial staff to ensure schedules are managed well to achieve targeted productivity and clinic budget.… more
- HCA Healthcare (Loxahatchee, FL)
- …contracting issues. + Provides medical consultation on contracting, pricing, and analysis of managed care issues. Offers clinical support for appeals and denials ... regarding delegated utilization management and disease management operations under managed care contracts. Meets all regulatory/contractual/accreditation requirements… more