- HCA Healthcare (San Antonio, TX)
- …+ Provides medical consultation on contracting , pricing, and analysis of managed care issues. Offers clinical support for appeals and denials process, ... regarding delegated utilization management and disease management operations under managed care contracts. Meets all regulatory/contractual/accreditation requirements… more
- HCA Healthcare (Overland Park, KS)
- … Care Coordinators + Facilitates specialty referrals, as appropriate, for conditions/needs managed outside the primary care realm + Documents efforts in ... as needed and performs medical record reviews for payor projects **Transitions of Care ** + Contacts patients after hospital discharge to identify the need… more
- Medtronic (Minneapolis, MN)
- …teams. This position will act as a subject matter expert in payer relations, managed care contracting , and market access. In today's rapidly evolving ... + Strong knowledge of fee-for-service payment systems, coding (HCPCS/CPT, ICD-10), and managed care contracting . + Established relationships with key… more
- The Cigna Group (Bloomfield, CT)
- … Healthcare experience environment, required.** + **4+ years Financial Analysis experience in Managed Care , required.** + **Ability to analyze and interpret both ... operational costs, always focusing on results. + In-depth understanding of managed care business processes, data, systems, reimbursement methodology, case-mix… more
- The Cigna Group (Richmond, VA)
- …strong working relationships within a fast paced matrix organization. + Working knowledge of hospital , managed care , and provider business models. + Strong ... position serves as an integral member of the Field Contracting Team. This role is primarily responsible for monitoring...Microsoft Access skills a plus. + Experience with health care Commercial and IFP products a plus + Strong… more
- Baylor Scott & White Health (Dallas, TX)
- …of 5 years of progressive experience in healthcare revenue cycle, payer relations, or managed care contracting . Experience in a matrixed or integrated ... This role serves as a critical liaison between Revenue Cycle leadership and Managed Care leadership to support and streamline payer communications. The Director… more
- CommonSpirit Health (Englewood, CO)
- …reimbursement rates and associated language, between physicians/hospitals and payers/networks for managed care contracting initiatives. Develop and approve ... This position requires daily contact with senior management, physicians, hospital staff, and managed care /payer strategy leaders. + Lead payer contract… more
- UHS (Binghamton, NY)
- …OverviewUnited Health Services (UHS) is seeking a detail-oriented Contract Technician to join our Managed Care Contracting team. In this role, you will ... review and improve hospital , homecare, and physician contract management within the Epic... is delivered. Primary Department, Division, or Unit: UHS Managed Care Contracting Primary Work… more
- The Cigna Group (Atlanta, GA)
- …+ Intimate understanding and experience with larger, more complex integrated delivery systems, managed care , and provider business models + Team player with ... complex delivery systems and organizations required** + Experience with Physician, Hospital and Ancillary group contracting and negotiations + Experience… more
- The Cigna Group (Austin, TX)
- …for meeting the plan results **Qualifications** + 5+ years' of experience in health care / managed care work experience + Strong Experience with various data ... with standard medical coding: CPT, ICD9, HCPC preferred + Understanding of managed care business processes, data, systems, and applications for claims… more