• Senior Contract Manager Analyst - Mount Sinai…

    Mount Sinai Health System (New York, NY)
    …- our goal is to keep entire communities healthy and out of the hospital . Mount Sinai Health Partners (MSHP) is the team driving this transformation within Mount ... implementation and contract compliance related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as… more
    Mount Sinai Health System (07/30/25)
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  • Case Management Representative - Full Time - Days

    Houston Methodist (The Woodlands, TX)
    …needs, as directed, and in collaboration with the clinical team. Follows payor/ reimbursement practices and regulations that may impact the patient's plan of care ... FUNCTIONS** + Assists the department in distributing required notices, including the Medicare Notice of Discharge to patients, securing signatures on the form from… more
    Houston Methodist (09/06/25)
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  • Eligibility Specialist

    CommonSpirit Health Mountain Region (Pueblo, CO)
    …Specialist serves as a liaison between the client, physician, community agency, hospital , and governmental agencies; and is actively involved in all areas of ... Emergency Medicaid for undocumented individuals,. Some clients may also need assistance with Medicare , Medicare Part D, Medicare Savings Programs, … more
    CommonSpirit Health Mountain Region (09/12/25)
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  • Director of Managed Care Contracting

    Stony Brook University (Commack, NY)
    …support Joint Operating Committee (JOC) meetings, contract settlement discussions, and reimbursement escalations. + Ensure compliance with Medicare and Medicaid ... + Oversee and direct the negotiation, execution, and administration of all hospital , physician, and ancillary Managed Care contracts. + Maintain accurate, up-to-date… more
    Stony Brook University (08/08/25)
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  • Case Manager (RN) | Case Management & Social Work

    Houston Methodist (Houston, TX)
    …physicians of timely disposition options to assure maximum benefits for patients and reimbursement for the hospital . + Applies approved utilization criteria to ... are medically necessary, communicating clinical information to payors to ensure reimbursement . **PEOPLE ESSENTIAL FUNCTIONS** + Communicates in an active, positive… more
    Houston Methodist (08/30/25)
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  • Senior Financial Analyst, Revenue Cycle Management

    Stony Brook University (Stony Brook, NY)
    …experience in charge/ reimbursement analysis, maintenance, audit or review for a Hospital Finance or Revenue Cycle Department. + Strong working knowledge of CPT, ... + Experience with inpatient and outpatient billing requirements (UB-04) and CMS Medicare and New York Medicaid reimbursement methodologies. + Knowledge of… more
    Stony Brook University (08/12/25)
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  • RN Care Manager

    AdventHealth (Kissimmee, FL)
    …community you will be caring for:** + AdventHealth Kissimmee is a 242-bed community-focused hospital + Conveniently located near Walt Disney World + The team is here ... of Nursing and is responsible for patient evaluations of post- hospital needs; development of a transition of care plans...remove barriers to timely and efficient care delivery and reimbursement . The RN Care Manager provides education to nurses,… more
    AdventHealth (09/11/25)
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  • Director Managed Care Contracting

    Houston Methodist (Houston, TX)
    …outs, new procedures, new drugs. Analyzes proposals which include capitation reimbursement , Medicare resource-based revenue value scale (RBRVS) values, current ... maintenance and payer relations of the Houston Methodist (HM) contracts for reimbursement of services billed through managed care companies and serves as a… more
    Houston Methodist (09/12/25)
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  • Facility Coding Inpatient DRG Quality

    Banner Health (AR)
    …Demonstrates extensive knowledge of clinical documentation and its impact on reimbursement under Medicare Severity Adjusted System (MS-DRG),All Payer Group ... production role but does require coding proficiency and recent Hospital Facility Coding experience.** This position is task-production-oriented ensuring quality… more
    Banner Health (09/06/25)
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  • HIM Clinical Coding Specialist III - System Coding…

    Sharp HealthCare (San Diego, CA)
    …Procedural Coding System (HCPCS) codes to assure appropriate assignment for outpatient Medicare reimbursement .Reviews and verifies charges to assure an accurate ... Association (AHIMA); HS Diploma or Equivalent; Certified Procedural Coder - Hospital (CPC-H) - American Academy of Professional Coders (AAPC); Registered Health… more
    Sharp HealthCare (08/15/25)
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