- Beth Israel Lahey Health (Charlestown, MA)
- …to the Supervisor, Billing. 11. Keeps informed of all federal, state, and managed care contract regulations, maintains working knowledge of billing ... and in accordance with the law. **As a health care organization, we have a responsibility to do everything...a responsibility to do everything in our power to care for and protect our patients, our colleagues and… more
- Catholic Health Services (Melville, NY)
- …established standards and procedures. + Follows up on payer payment variances. Applies managed care contract rules to determine payment accuracy. Reports ... and human services agencies. Our health system has over 16,000 employees, six acute care hospitals, three nursing homes, a home health service, hospice and a network… more
- Ivyhill Technologies LLC (Bethesda, MD)
- …treatment capabilities and capacity for Product Lines/Specialties assigned. Proactively collaborates with Managed Care Support Contract (MCSC), Product Line ... currently seeking to hire a Registered Nurse (Non-Practicing) to support its contract with the Integrated Referral Management and Appointing Center (IRMAC), the… more
- Prime Healthcare (Sherman Oaks, CA)
- …of contract interpretation 4. Familiar with hospital billing requirements 5. Understanding of managed care payor contract and contract language 6. ... Overview Sherman Oaks Hospital is a 153-bed, not-for-profit, acute- care community hospital located in Sherman Oaks, California....the hospital is recognized for advanced technology and compassionate care and provides 24/7 emergency care in… more
- Saint Francis Health System (Tulsa, OK)
- …performs on going analysis, which maintains the integrity of financial expectations of managed care contracts within the Epic system. Resolves programming issues ... - 5:00pm Job Summary: Responsible for analysis of contracts and performing contract negotiations to include monitoring and reviewing existing contracts to ensure… more
- Humana (Springfield, IL)
- …to manage multiple priorities in a fast-paced environment. + Thorough understanding of managed care contracts, including contract language and reimbursement. ... trainings. + Attend Network Meetings/Conferences. Ensure compliance with all Virginia managed care contractual requirements for provider relations, such as… more
- Humana (Oklahoma City, OK)
- …health providers, facilities and/or FQHCs is strongly desired + Understanding of managed care contracts, including contract language and reimbursement ... interactions with Humana's Oklahoma Medicaid plan + Ensure compliance with Oklahoma's managed care contractual requirements for provider relations, such as… more
- MyFlorida (Tallahassee, FL)
- …the development of policy language for: Medicaid contracts and amendments, Medicaid managed care report guides, contract interpretations, policy ... 1115 waivers and home and community-based waivers), administrative rules, coverage policies, managed care plan contracts, bill analyses, drug utilization review… more
- Zions Bancorporation (Midvale, UT)
- …business areas. The successful candidate will have experience with handling pharmacy contracts, managed care contracts, or other contract background; be able ... UT. This position will assist with management of the contract lifecycle for our clients, including template setup, ...+ Health Savings (HSA), Flexible Spending (FSA) and dependent care accounts + Paid Training, 15 days of Paid… more
- Cedars-Sinai (CA)
- …with respect to regulatory and contract language for Commercial, Medicare and Medi-Cal managed care . + Acts as a liaison with health plans and current CSHS ... **Job Description** The Managed Care Compliance Specialist is responsible...regulatory requirements. + Maintains and tracks laws and regulations, contract documentations, amendments, and various compliance measures pertaining to… more