- AdventHealth (Altamonte Springs, FL)
- …**Responsible for ensuring the providers are loaded timely and accurately with Managed Care contracted payers. Responsible for evaluating professional fee ... (PE) and works closely with practice office operations staff, Managed Care (MC) contracting, MC Credentialing and...received from the payers in Athena/Epic and MSOW Network Management thus releasing held claims and updating the status… more
- Elevance Health (Southport, NC)
- …families thrive in safe, stable, and nurturing homes._ The **CFSP Managed Care Coordinator** is responsible for the overall management of the member's ... **CFSP Managed Care Coordinator** **Sign-on Bonus: $2500**...services and supports, Unmet health-related resource needs, and Integrated care management . We envision a North Carolina… more
- Atrius Health (Newton, MA)
- …welfare benefit package. **Job:** **Accounting/Billing/Finance* **Organization:** **Finance* **Title:** *Senior Managed Care Analyst* **Location:** *Newton MA - ... Atrius Health, an innovative healthcare leader, delivers an effective system of connected care for more than 690,000 adult and pediatric patients at 30 medical… more
- Elevance Health (VA)
- …for employment, unless an accommodation is granted as required by law._ The ** Managed Care Coordinator Clinician Non-RN** is responsible for working under the ... responsibility for the member's case, as required by applicable state law and contract , contributes to the care coordination process by performing activities… more
- InGenesis (Columbia, SC)
- InGenesis is currently seeking a Registered Nurse / RN - Managed Care Coordinator to work for our client located in Columbia, SC. In this role you will review ... of clinical information to support and determine medical necessity criteria and contract benefits. * Utilize allocated resources to back up review determinations. *… more
- AdventHealth (Maitland, FL)
- …revenue. Provides guidance and direction to PFS, Central Denials, Patient Access and Managed Care staff regarding contract terms and policies including; ... building and maintenance of rates and terms into designated contract management systems for Florida and multi-state...is not compromised. * Responsible for timely entry of contract data into the Managed Care… more
- AdventHealth (Maitland, FL)
- …managed care contracting initiatives as directed by AdventHealth leadership; managed care contract review, interpretation and analysis, negotiation, ... the integrity of those contracts. Shows full comprehension of managed care contract language for...management , and other related issues through application of managed care expertise, ongoing regular job duties,… more
- AdventHealth (Maitland, FL)
- …adjudication. Provides guidance and direction to PFS, Central Denials, Patient Access and Managed Care staff regarding contract terms and policies including; ... building and maintenance of rates and terms into designated contract management systems for AdventHealth Florida Division...contract data elements which are populated into the Managed Care database including addition of new… more
- Pfizer (Lake Forest, IL)
- …books of business: Pfizer Sterile Injectables, Surgical, Oncology and Diagnostic products. The Contract Management Team is a business team within the Market ... regulations of the pharmaceutical industry and Pfizer Policies. **ROLE RESPONSIBILITIES** CONTRACT MANAGEMENT + Develop contractual proposals and agreements in… more
- BrightSpring Health Services (Louisville, KY)
- …understanding of trade relations, reimbursement processes, government programs, managed care , formulary management , and contract negotiation + Proficient ... ensuring optimal use of CRM tools, accurate reporting, and effective workflow management for the Sales Operations team. By supporting the physician sales force,… more