- Fairview Health Services (Minneapolis, MN)
- …functions, ensuring Fairview remains a nationally competitive, value-based partner across health plans, PBMs, and employer coalitions. The ideal candidate brings ... deep, direct experience in PBM or Payer ( Health Plan) environments, and can translate complex clinical, financial,...payer strategy within a specialty pharmacy, PBM (Pharmacy Benefit Manager ), and/or managed care setting. + 7 years Prior… more
- East Boston Neighborhood Health Center (Revere, MA)
- Thank you for your interest in a career at NeighborHealth, formerly East Boston Neighborhood Health Center! As one of the largest community health centers in the ... greater Boston area with a strong commitment to the health and well-being of our patients and communities. Whether...you're a nurse or physician providing direct care, a manager leading dedicated teams, or part of the essential… more
- Amentum (Washington, DC)
- …claim review team leads and supervisors and, under the supervision of the Claims Manager , the Claim Review Assessor performs pre-screen, claim preparation, ... crashes. The original VCF operated from 2001-2004. In 2011, the James Zadroga 9/11 Health and Compensation Act of 2010 was signed into law and reactivated the… more
- Children's Mercy Kansas City (Kansas City, MO)
- …external requests for certificates of insurance, certificates of liability coverage, and claims histories. + Assists the Insurance Program Manager with ... and we strive to say thanks by giving back. As a leader in children's health , we engage in meaningful programs and partnerships throughout the region so that we can… more
- Deloitte (Fresno, CA)
- …vendors by reviewing services, contracts, performance guarantees, and renewals. + Analyze claims utilization data and assess health plan performance against ... Work you'll do + Prepare self-insured financial projections and support health plan management, including financial reporting, premium rate setting, and employee… more
- BronxCare Health System (Bronx, NY)
- Overview Reports to Manager of Unit Associates and works on Patient Care Units to perform clerical and receptionist duties related to the day-to-day operations of ... and coordination of Patient Care Services under the Patient Care Manager of the designated unit. Responsibilities 1. Describe responsibility:Establish and maintain… more
- Highmark Health (Nashville, TN)
- **Company :** Allegheny Health Network **Job Description :** **_*This role will cover Inpatient Auditors and will require Inpatient (AHIMA) credentials._** **GENERAL ... the Standards of Ethical Coding as set forth by the American Health Information Management Association and Corporate Compliance Coding Guidelines. Assures compliance… more
- Baystate Health (Springfield, MA)
- Baystate Health , Western Massachusetts's premier healthcare provider, and home to Baystate Medical Practices, the largest multispecialty group in the region, is ... by the Director. May receive directions from the Practice Supervisor, Practice Manager , and other members of the Service Line/Department leadership team. The… more
- CVS Health (Lumberton, NJ)
- At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming ... health care. As the nation's leading health ...supporting business operations. This position reports to the IQC Manager and collaborates across the supply chain network to… more
- Travelers Insurance Company (Franklin, TN)
- …Identifies and refers claims with Major Case Unit exposure to the manager . + Performs administrative functions such as expense accounts, time off reporting, etc. ... to develop skills for investigating, evaluating, negotiating and resolving claims on losses of lesser value and complexity. Provides...- required. **What Is in It for You?** + ** Health Insurance** : Employees and their eligible family members… more