- Stony Brook University (East Setauket, NY)
- …and denied accounts. + Collaborates on denials prevention initiatives. + Liaises with Managed Care Contracting and Insurance Company Provider Representatives ... Care Hospital Revenue Cycle or Patient Accounting Department resolving hospital Managed Care payment variances and/or denials. **Job Responsibilities may… more
- Mount Sinai Health System (New York, NY)
- …+ Experience working in healthcare provider analytics related to revenue modeling, managed care contracting , population management, case management, clinical ... ongoing performance and identify trends in performance to inform our clinical or contracting staff to improve contract outcomes. b. Care Management Helps to… more
- Mount Sinai Health System (New York, NY)
- …+ Experience working in healthcare provider analytics related to revenue modeling, managed care contracting , population management, case management, clinical ... ongoing performance and identify trends in performance to inform our clinical or contracting staff to improve contract outcomes. 2. Care Management - Helps… more
- Blue KC (MO)
- …or more years of progressive experience in population health, behavioral health integration, or managed care strategy within a payer or provider organization ... behavioral health and health outcome leadership. + Partner with contracting , product, and network operations to align provider performance,...KS required. + 5+ years of experience in integrated care , managed care , or population… more
- J&J Family of Companies (Raritan, NJ)
- …our Enterprise Contract Solutions in Raritan, NJ! Johnson & Johnson Health Care Systems Inc. (JJHCS) provides contracting , supply chain, business services, ... New Jersey, United States of America **Job Description:** Johnson & Johnson Health Care Systems Inc., a member of Johnson & Johnson's Family of Companies, is… more
- Takeda Pharmaceuticals (Boston, MA)
- …key stakeholders preferred + Strong knowledge of US access market dynamics and how managed care organizations (ie, PBMs, National and Regional Payers, IDNs etc) ... forecast, build bottoms up coverage forecast, and partner with PVA teams on contracting strategy and scenario planning for GPO and Payers (across segments and… more
- BrightSpring Health Services (Huntsville, AL)
- …contract negotiations with agencies, funding sources, facilities, insurance companies, and managed care organizations + Supports and promotes company philosophy ... staff. Works closely with support departments to achieve + Routine collaboration with payer contracting to negotiate the strongest contracts + Monitor metrics… more
- BrightSpring Health Services (Newark, NJ)
- …contract negotiations with agencies, funding sources, facilities, insurance companies, and managed care organizations + Supports and promotes company philosophy ... staff + Works closely with support departments to achieve routine collaboration with payer contracting to negotiate the strongest contracts + Monitors metrics… more
- CareFirst (Baltimore, MD)
- …experience on the payer side using MCG criteria. Working knowledge of managed care and health delivery systems. + Thorough knowledge of CareFirst clinical ... prospective, concurrent and retrospective reviews for authorization, appropriateness of care determination and benefit coverage. Leveraging clinical expertise and… more
- Penn Medicine (Bala Cynwyd, PA)
- …group practices + Knowledge of the medical environment, physician group practice, managed care , physician compensation, healthcare contracting and ... Ensures practices are aligned with all standards. Supports implementation of managed care contracts and operational processes. Communicates performance targets… more