- BrightSpring Health Services (Nashville, TN)
- …resolving billing-related issues. This position will work in collaboration with Contracting , Field Branch Operations, Credentialing, and central functions at Support ... departments to resolve and expedite solutions. + Partner with contracting and operations teams to evaluate collection capabilities and...plans. Ensure that the productivity and actions of the managed group meet and support the quality goals. +… more
- Johns Hopkins University (Baltimore, MD)
- …Subject matter expertise in the administration and operation of health insurance and managed care programs, including Medicaid and Medicare Advantage. + Deep ... understanding of the regulatory environment for managed care , including CMS requirements, state/federal regulations, risk-bearing arrangements, and compliance… more
- Baylor Scott & White Health (Dallas, TX)
- …correspondence to collect inaccurate insurance payments and penalties according to BSWH Managed Care contracts. Maintains collection files on the accounts ... to resolve payment difficulties and penalties owed to BSWH in accordance with Managed Care contracts. Contacts insurance company representatives by telephone or… more
- Dragonfly Health (AZ)
- …obtained through work experience, education or training * Durable medical equipment, pharmacy, managed care , or other pertinent health care services industry ... to boost operational efficiencies, contain costs, enhance quality of care , and ultimately increase patient satisfaction. With our innovative technology… more
- Chenega Corporation (Rockville, MD)
- …and Task specific knowledge of worker's compensation, injury compensation programs, or managed care . + Professional Background: Relevant experience in claims ... to provide daily and effective contact and communication with the HRSA CICP Contracting Officer's Representative (COR), Contracting Officer (CO), Contracting … more
- CareFirst (Baltimore, MD)
- …years experience in risk adjustment coding, ambulatory coding and/or CRC coding experience in managed care ; state or federal health care programs; or health ... submissions. Utilizes coding expertise, combined with medical policy, credentialing, and contracting rules knowledge to build the effective guides and resources for… more
- Kelly Services (Titusville, NJ)
- …Science project in Major Depressive Disorder MDD, conducted with health care organizations. MAJOR DUTIES AND RESPONSIBILITES + Collaborate closely with the ... overall research project management, including budget management and invoicing, contracting processes, and obtaining needed approvals. + Responsible for monitoring… more
- Molina Healthcare (Des Moines, IA)
- …health care vendor, commercial health insurance, large physician practice, managed care organization, etc.) * Advanced proficiency with retrieving specified ... utilized in medical coding/billing (UB04/1500 form). * Advanced understanding of key managed care concepts and provider reimbursement principles such as risk… more
- HCA Healthcare (Nashville, TN)
- …various teams, including payer contracting and analytical teams, payer relations, managed care , legal support, and service line leaders. Your primary ... best practices when collaborating with customers and peers. + Assist the Payor Relations Managed Care teams and Managed Care Legal teams in proactively… more
- Takeda Pharmaceuticals (Boston, MA)
- …specialty pharmacy, etc.) + Understanding of US payer market dynamics and how managed care organizations make decisions across commercial and public channels + ... You will also be responsible for value story development, payer/PBM contracting strategy, pricing, specialty pharmacy and distribution plans, and payer/channel… more